Report prepared by Margaret Roper and Kate Roper

Edited by Cheryl Goodenough March 2007

Documenting strategies
of the Australian Partnerships
with African Communities
program partners
contents
Acknowledgements
Developing a publication of this nature
is a collaborative effort. Thanks go to
the following individuals, groups and
organisations for their willingness to work
together and share their experiences:
The management, staff, volunteers and
communities of the Oxfam Australia partner
organisations in both Mozambique and
South Africa. In Mozambique, the National
Union of Small Farmer Associations
(UNAC) and Mozambique Network of AIDS
Service Organisations (MONASO), and in
South Africa, YMCAAmanzimtoti, Targeted
AIDS Intervention, Centre for Positive Care,
Comprehensive Health Care Trust and Bela
Bela HIV and AIDS Prevention Group.
Financial support for this program was
given by AusAID (cooperative agreement
09790/11), as part of the Australian
Partnerships with African Communities.
Oxfam Australia staff in South Africa,
Mozambique and Australia.
The opinions of authors or participants
expressed in the document do not
necessarily refect those of Oxfam Australia,
Oxfam affliates, AusAID or any of their staff.
1. Introduction 4
2. Review of literature and research 5
3. Case studies 6
3.1. Uniao nacional de camponenes (UNAC), Mozambique 6
3.2. Monaso in Sofala, Tete, Gaza and Inhambane provinces,
Mozambique 7
3.3. Centre for Positive Care (CPC) in limpopo province, South Africa 9
3.4. Amanzimtoti YMCA in Kwazulu-natal province, South Africa 10
3.5. Targeted Aids Intervention (TAI) in Kwazulu-natal province,
South Africa 12
3.6. Bela Bela HIV and AIDS prevention group in Limpopo province,
South Africa 14
3.7. Choice comprehensive health care trust in Limpopo province,
South Africa 16
4. Summary 18
5. Lessons 20
Lesson 1: Protocols and fow for community entry and engagement 20
Lesson 2: Capacity building for good governance 20
Lesson 3: Integrating whole community development 21
Lesson 4: Build relationships between state, civil society and community 21
Lesson 5: Expanding circles of infuence 21
6. Conclusion 22
Cover: Community members in Cupo, Mozambique take part in discussions
regarding a food security program which Oxfam supports through its local partner
UNAC. Photo: Paul Weinberg/OxfamAUS.
This page: Oxfam supports partners in Mozambique to develop income-generating
projects such as sewing and handicrafts for people living with HIV and AIDS.
Photo: Joel Chiziane/OxfamAUS.
3
4 5
1. Introduction
The Australian Partnerships with African
Communities (APAC) program aims for
men and women in 132 southern African
communities to lead their own development,
address the impacts of HIV and AIDS, have
increased food security and access to basic
social services. The fve-year initiative aims
to achieve these objectives by 2008. It is
supported by the Australian government and
implemented by two Oxfam Australia partner
organisations in Mozambique and fve in
South Africa.
The APAC program has three objectives:
Achieve food sovereignty through
building community capacity
Building a network to improve
the quality of the responses to
HIV and AIDS
Creat a more enabling environment
for HIV and AIDS programs.
This report explores theoretical approaches
to community development focusing on
community engagement and highlights
emerging best practice in community
entry strategies for HIV and sustainable
livelihood development projects. It considers
the community engagement strategies
undertaken by the seven partners working
on the APAC program and identifes the
approaches that they use, highlights the
strengths and challenges they encounter
in their strategies and discusses common
trends that have emerged from a study of
the various approaches. The report also
provides lessons and recommendations that
emerge from the fndings to inform further
community engagement practice.

2. Review of literature and research
A review of literature and research into
the community development approaches
of the seven APAC partners indicates the
need to unpack the concepts of community
engagement as differing from community
entry strategies. In general, community
development approaches do not necessarily
differentiate these concepts as strategic
intervention phases. This report suggests
that community entry and community
engagement involve different processes,
and are dependent on the emergence
of the project.
Development organisations uniformly
state that community participation and
involvement are essential for success. In the
literature reviewed the terms community,
participation and involvement are used
loosely and each has a range of meanings.
The term community is sometimes used
to refer to a geographical community or it
may refer to a community of interest. The
terms participation in development and
participatory approaches to development
are used so widely that they have almost
lost their meaning. They were introduced to
emphasise the importance of people having
control over their own development, but are
now used in situations where people have
little control, or where people are allowed
to participate in a limited way.
1

Development practitioners need to recognise
genuine participatory development, and
always strive for genuine participation in
community-based development work.
In social learning theory
2
, learning is
considered a social phenomenon and
takes place in the context of our lived
experience and participation in the world.
Learning takes place when individuals
are active participants in the practices of
social communities. Transformation takes
place through individuals belonging to and
participating in communities, doing things in
practice, gaining experience and confdence
and ultimately gaining a new identity.
Rights-based approaches to development
take as their foundation the need to promote
and protect human rights. Human rights have
been recognised by the global community
and are protected by international law.
These include civil and political rights
(eg, freedom of speech, religion, political
affliation and assembly) and economic,
social and cultural rights (eg, rights to health,
education, shelter, land, a livelihood), all of
which are interdependent.
3
Development programs guided by human
rights focus on respecting human dignity,
achieving fairness in opportunities and equal
treatment for all and strengthening the ability
of local communities to access resources
and services.
Sector-wide approaches focus on the overall
effectiveness of a particular sector, such
as health, agriculture or education, and
combine institutional development, policy
dialogue and service delivery.
introduction review
Learning takes place
when individuals are
active participants
in the practices of
social communities.
Transformation
takes place through
individuals belonging
to and participating in
communities, doing
things in practice,
gaining experience
and condence and
ultimately gaining
a new identity.
Women attend a community meeting in Cupo, Mozambique to discuss UNACs food security program.
Under the program, cattle, vegetable seeds and tools have been distributed and several agricultural extension
workers trained, to help the community learn to care for their cattle and cultivate vegetables.
Photo: Paul Weinberg/OxfamAUS.
1Waad El Hadidy, Alison Mathie, Gord Cunningham, Laila, Megan Foster. Coady ABCD manual. Center for Development Services and Coady International Institute; St Francis Xavier University
2Alec Couros (2003)Communities of Practice: A Literature Review; For Dr. Cyril Kesten; Faculty of Education, University of Regina; http://educationaltechnology.ca/ couros/ publications/ unpublishedpapers/communities_practice.pdf
3DFID. Guidance notes on Sustainable Livelihoods. http://www.livelihoods.org/info/info_guidancesheets.html
6 7
3. Case studies
3.1. Uniao nacional de camponenes
(unac), mozambique
Purpose and origins of organisation
Uniao Nacional de Camponenes (UNAC)
is a membership-based organisation that
works to improve the livelihoods of small
agricultural producers or peasant farmers,
based on the principles of food sovereignty
and self-determination. UNAC was
offcially registered as a non-government
organisation (NGO) in 1994.
The APAC programs support aims to
strengthen the capacity of communities to
achieve food sovereignty in two districts of
Inhambane province by building community
structures that enable communities to plan
and control their own development. This is
achieved through building local capacity to
identify and respond appropriately to food
insecurity and the impact of HIV and AIDS
through association building, technical
training and agricultural input. In addition,
APAC focuses on building the capacity
of UNAC as a national umbrella body
to respond to the challenges facing
its members.
Community engagement strategy
The role of the partnership between
UNAC and APAC is to assist communities
to engage with locally-based farming
associations to minimise some of the
problems the communities face. This
is based on the understanding that
sustainable development must be owned
and directed by the people it affects and
this requires strong local organisation.
The role of the unions is to establish a
movement to build member capacity to
engage in their own development and
to facilitate government service delivery.
Projects are implemented by member
associations rather than at other levels.
Capacity development focuses on advocacy,
agricultural training, organisational skills
development and how communities can
respond to challenges such as the impact
of HIV and AIDS. A key strategy is to
increase the level of participation of
members in collectively cultivating seed,
planting trees, and deciding what crops
to plant through local practice.
Benefts of being part of UNAC include
access to and sharing of technical expertise
and organisational development skills, as
well as the establishment of agricultural
projects for community beneft and improved
land management. In addition, member
organisations have increased understanding
and practice of how a community can
respond to the challenges and problems
they face by identifying their own problems
and developing strategies to overcome
them. Members develop an understanding
of what it means to be poor and connect
and build solidarity with people in different
provinces, countries and continents who are
in a similar position. Member associations
are also able to develop an understanding of
their rights and be part of a movement that
can help them to achieve these rights.
Challenges and strengths
One of the challenges UNAC faced is that it
is diffcult for poor people to be self-suffcient
in their own community development.
UNAC strives to ensure that communities
do not become donor dependent as this
undermines the capacity building process
required in sustainable community
development practice. This is
a diffcult process because communities
face the reality of dealing with immediate
needs, such as hunger, as well as
long-term development needs.
3.2. Monaso in Sofala, Tete, Gaza and
Inhambane provinces, Mozambique
Purpose and origins of organisation
MONASOs role is to capture the willingness
of people to prevent and mitigate the
results of HIV and AIDS and channel this
willingness into worthwhile activities. To this
end, MONASO supports community-based
organisations in geographical communities
and network organisations at district level.
MONASO helps to build capacity through
training courses, seminars, exchange visits,
information sharing initiatives, referrals,
advocacy and other support from its
provincial and national offces. As a network
organisation, MONASO aims to expand the
response to HIV and AIDS countrywide.
MONASO focuses on three strategic
areas: building the capacity of member
associations, building the capacity of
MONASO to meet member needs, and
information sharing and communications.
Community engagement strategy
MONASO was established by the founding
member organisations through a process
facilitated by the regional movement of
networks, AFRICASO. In slightly more
than a decade the organisation grew to
an average national membership of 150
organisations. Member numbers are fuid
as new organisations form and join, others
change direction and others close.
In addition to national and provincial
meetings, MONASO staff visit each
organisation regularly to identify training
needs, identify potential donors and
network with organisations to inform plans.
Training courses and seminars cover
organisational development issues like
fnancial management, project management
and leadership, as well as technical training
like home-based care. Seminars build
the ability of member organisations to
advocate for change, overcome stigma and
discrimination, and share knowledge and
experience. A monthly newsletter provides
a platform for sharing information and
member experiences.
MONASO plays an advocacy role at
a national level, sits on the national and
provincial AIDS councils and the government
agency distributing donor and government
funds for HIV and AIDS interventions, and
continues to mobilise new organisations to
address HIV and AIDS related issues.
Member organisations comprise volunteers;
very few receive any remuneration and
resources of all kinds are scarce. At ward
and village level, organisations involve a
wide range of stakeholders through the
support of community leaders; participating
in and publicising their work at community
meetings, mobilising vulnerable people who
are strong enough to work, and encouraging
civil servants to identify vulnerable people,
youths, children and carers who need
additional support.
case studies
A key strategy
is to increase the
level of participation
of members in
collectively cultivating
seed, planting trees,
and deciding what
crops to plant through
local practice.
MONASO focuses on three strategic
areas: building the capacity of member
associations, building the capacity of
MONASO to meet member needs, and
information sharing and communications.
A woman carries a jerry can of water to the
vegetable felds in Mavume. Through UNACs food
security program, wells have been, as well as seeds,
tools and agricultural training to enable community
members to grow a great variety of vegetables.
Photo: Paul Weinberg/OxfamAUS/OxfamAUS.
8 9
Challenges and strengths
Challenges include the fuidity of
membership and weak links between
civil society organisations and government,
as well as weakness of local government
structures. In addition, there is a need for
civil society organisations to contribute
more to poverty reduction strategies, play a
greater role at district and community levels,
and for the young member associations,
in particular, to grow into the roles of
service delivery, monitoring and advocacy.
MONASO staff believe that donors have
only recently started building a long-term
response to poverty; the focus had been on
humanitarian aid. MONASO is challenged
by the scarcity of professionals, with only
600 doctors serving 15 million people. In
addition, literacy levels are extremely low,
clinics are scarce with people travelling up
to 20 kilometres to the nearest clinic and
civil society organisations need to play
a role in service delivery.
Benefts for member associations of being
part of MONASO include opportunities
for training and support. Experiences and
information are shared regularly and a
bigger voice is created by those who
join together to advocate for change at a
political level. This approach also increases
understanding and practice of how a
community can respond to the challenges
and problems they face by identifying their
own problems and developing their own
strategies to overcome them.
3.3. Centre for Positive Care (cpc)
in Limpopo province, South Africa
Purpose and origins of organisation
The Centre for Positive Care (CPC) supports
approximately 1,000 volunteers in four
districts in the northern part of the Limpopo
province. The organisation focuses on peer
education programs and home-based care
services. CPCs vision is to reduce the
spread of Sexually Transmitted Infections
(STIs) HIV and AIDS and improve the quality
of life for people living with and affected by
HIV and AIDS.
CPC works with volunteers to offer
services in three main areas:
Preventing HIV and AIDS through peer
education and lay counselling.
Providing community home-based care
services to ill clients in their homes and
supporting the DOTS treatment program
for tuberculosis.
Identifying orphans and vulnerable
children and offering care and support
to help create an enriching environment
for children to grow up into healthy
and productive members of their
communities.
Community engagement strategy
The project was originally initiated externally
from the communities and community
engagement was based on raising
awareness through public broadcasts and
school talks, and meetings with community
stakeholders. As volunteers came on board,
and were trained in public health awareness
around STIs, community stakeholders
requested more information. As the project
grew, communities themselves were
requested to identify volunteers, particularly
women, to assist in the roll-out of the
projects. The emphasis of the public health
awareness program initially focused on the
prevention and treatment of STIs, which
the community is generally more open to
discussing, after which volunteers are able
to address issues of HIV and AIDS.
When CPC begins to work in a new
community the emphasis initially is on
engaging with the key stakeholders to
gain broad-based support and buy in
for the provision of health program. Key
to the success of the CPCs work is the
establishment of working relationships with
the local traditional leaders. Once active
support has been gained, a baseline survey
is undertaken by trained youth from the
community to identify the health problems in
the area. Once completed, the stakeholders
organise a community meeting to present
the fndings and engage with community
members in selecting projects and
developing processes to select volunteers to
implement the identifed projects. If support
from the community is not obtained, the
implementation phase is delayed until such
time as active engagement is evident.
External people are not brought into the
community; the members must do it for
themselves. In order to do this, CPC
mobilises government resources, particularly
training program, to support community
and rural development. CPC facilitate and
encourage community-based volunteers
to make the links with government and
establish the partnerships themselves.
If they are unable to do this, then CPC
intervenes to support the volunteers.
Challenges and strengths
Challenges include the lack of reliable
statistics from the clinics and inadequate
allowances for volunteers. Parallel and
duplicated home-based care services
initiated by local community-based
organisations through funding from various
sources could also pose a threat to existing
services offered by non-government
organisations. Duplication results in
confusion for the clients and wastage
of valuable resources.
Key to the success
of the CPCs work is
the establishment of
working relationships
with the local
traditional leaders. Dondo is a small community located in Sofala province, in the centre of Mozambique. In Sofala 26%
of the adult population is living with HIV, the highest prevalence in the country. MONASO supports a local
community-based organisation in Dondo which provides treatment support to people living with HIV and their
families, as well as orphans and vulnerable children. Photo: Joel Chiziane/OxfamAUS.
10 11
3.4. Amanzimtoti YMCA in
Kwazulu-natal province, South Africa
Purpose and origins of organisation
The vision of Amanzimtoti YMCA is to
develop young people holistically in order
to transform their communities into a place
where Christian values and principles are
practised. The YMCA is an international
youth membership organisation based on
volunteerism. The purpose of the APAC
partnership with Amanzimtoti YMCA is to
create a more enabling environment for
HIV and AIDS programs.
The current focus of Amanzimtoti
YMCA is on three projects:
A juvenile halfway house for young
people aged 18 to 23 who are in confict
with the law.
Support groups for young people
infected or affected by HIV and AIDS.
An APAC-supported youth project
focusing on edutainment, youth clubs
and youth entrepreneurship. The aim of
this project is to intensify HIV and AIDS
interventions in communities through
strengthening youth participation in
community development. A youth
centre has been established in the
KwaMakhutha area where young people
are able to meet and participate in the
project activities.
Community engagement approach
Amanzimtoti YMCA has worked in
KwaMakhutha for a number of years and
young people who were active in the
activities of the YMCA had previously
established a youth committee to address
the needs of youth in the area. The
KwaMakhutha youth committee, with the
support of the YMCA, conducted a baseline
study to identify the needs and challenges
of young people. The study found that most
young people were not involved in economic
activities as they lacked skills. They called
for a place where they could meet and
where services specifc to their needs
could be provided.
The youth centre was subsequently
established to address these needs through
providing entrepreneurship training, career
guidance, therapeutic interventions, drama
and debating clubs, and providing HIV
and AIDS prevention awareness. The
centre contributes to the development of
young people by enabling them to develop
their talents; provides awareness and
education in career guidance, life skills and
entrepreneurship; and engages them in their
own development. Support groups for young
people affected or infected by HIV and AIDS
also utilise the centre.
Young people are able to help identiffy
and prioritise project, training and resource
needs at the centres annual general
meetings. Other stakeholders involved
include the local clinic, church structures,
the local library, the Department of Social
Welfare, the South African Police Service,
tertiary colleges and schools, and local
NGOs and community based organisations.
Challenges and strengths
One of the challenges Amanzimtoti YMCA
faces is how to market the youth centre and
its activities to young people. The activities
they undertake must appeal to young people
and meet their needs. A further challenge
is the reality of working in a political context
with local government councillors, ward
structures and traditional leadership.
The centre contributes to the development
of young people by enabling them to
develop their talents; provides awareness
and education in career guidance, life skills
and entrepreneurship; and engages them
in their own development.
Young people attending one of Amanzimtoti YMCAs
entrepreneurship training sessions in KwaZulu-Natal,
South Africa. The centre contributes to the development
of young people by providing career guidance, life skill
and entrepreneurship training and support groups.
Photo: Matthew Willman/OxfamAUS.
A successful approach used by Amanzimtoti
YMCA has been the establishment of youth
clubs in schools. The aim of this approach is
that the learners will remain involved in the
YMCA and grow up to be active volunteers
and participants in community development.
12 13
3.5. Targeted Aids Intervention
(TAI) in Kwazulu-natal province,
South Africa
Purpose and origins of organisation
Targeted Aids Intervention (TAI) aims to
make a positive contribution to a healthy
society. TAI focuses its intervention on men
arguing that while men hold a position of
power in social interactions, it is through
training men to use their power creatively
that men might protect themselves and
thus their female partners. TAI targets the
behaviour of men and women by working
within the social system of gender inequality
and the contextual nature of gendered
relationships in KwaZulu-Natal.
TAI works closely with community structures
and the South African Football Association
to engage with men through the amateur
football network in the province. The
Shosholoza Project is an HIV and AIDS
education campaign operating through
the soccer network. The aim is to use
the language, beliefs and behaviour of
the young men to facilitate change in
risk behaviours, and to change the local
construction of hegemonic masculinity.
The purpose of the APAC partnership with
TAI is to create a more enabling environment
for HIV and AIDS programs.
Community engagement history
The focus of TAIs engagement with
communities is initiated through discussions
on preventing STIs after which young people
are open to engaging with issues of HIV.
This approach enables the work to be
incorporated into everyday activities; young
people become forerunners and are not
seen as volunteers. The forerunners take
the leadership in raising public health issues
and contribute to community empowerment
for social change. Issues addressed include
immunisation, home-based care, and STI
prevention and treatment.
TAI has been asked by community
structures, such as churches, schools and
gardening groups, to conduct presentations
about STIs and HIV. TAI provides
information and encourages people to raise
awareness in their communities and become
involved in community health projects.
However, TAI found that the community
structures lacked operational planning. As a
result they request a meeting with traditional
leaders to discuss further engagement
and support strategies in the particular
community in which they are working.
TAI agrees to facilitate the capacity
building of the structure or organisation
if the traditional leaders are supportive
and committed to the process.
TAI establishes a young mens committee
by inviting young men to come forward and
represent their community. They are asked
to bring a friend to a meeting where TAI
asks them how they would like to organise
themselves and, through the discussion,
the structure emerges.
The focus is on capacity building in action
TAI facilitates the discussion on what
the community want to do and discusses
with them the options they could take to
implement the action. The community
members identify the steps and gaps in their
skills to implement the action, and request
TAI for support in the strategic areas.
TAI pay the community-based organisations
to undertake the actual work in order to
strengthen the capacity building approach
and ensure that it takes place in a practical
and action-orientated setting. Young people
become skilled through practical community
development and apply what they have
learned beyond the health sector.
Prior to working in a community a
house-to-house baseline study is also
undertaken by community members
to understand demographic data and
community needs. This provides a sound
base on which to measure changes
over time and provides an opportunity to
individual community members to meet
and be exposed to TAI.
The Shosholoza
Project is an HIV
and AIDS education
campaign operating
through the soccer
network. The
aim is to use the
language, beliefs
and behaviour of
the young men to
facilitate change
in risk behaviours,
and to change the
local construction
of hegemonic
masculinity.
Engaging with men is challenging as
cultural and social constructs set gendered
relationships and behaviour and often
hinder open engagement to social and
health challenges. TAI promotes community-
based events, such as soccer matches,
which create opportunities for awareness
campaigns, demonstrations and discussions
about health issues that affect all community
members. The particular event begins once
the discussion is over.
are of concern to individuals. Organised
outings for youth committees members,
particularly in very rural settings, have been
essential in affrming and recognising the
voluntary nature of the work the young men
do, and for exposure to the constructs of
masculinity. Many have never experienced
fushing toilets, escalators or eating in a
canteen or restaurant. During these outings
young women are able to talk about how
they are treated and their views of men,
their mother-in-laws, gendered power
relations in sexual behaviour and traditions
that disempower them and maintain unfair
gender relationships. A further strength of
TAIs work is that many of the community
health workers from the clinics participate
in the activities and come to the training
sessions. They are very supportive of the
initiative and indicate that they have
learned much from TAI.
Challenges and strengths
The challenges TAI face include diffculties
around engagement with political and
government role players, taking into account
the historical contentions between political
parties. If political leaders are to speak at
a function they need to be briefed about
the purpose of the event so that they can
advocate clear and agreed messages in
support of community health. This is not
an easy process and events have caused
ruffed feathers.
Strengths include TAIs approach which
is concerned with community involvement
rather than participation. They regard
participation as members going to an event,
and community involvement as members
planning together, agreeing on actions to be
taken, solving problems together, and taking
action. The approach mobilises individual
strengths towards common issues that
These young men are participants in Shosholoza, a peer education program run by Targeted AIDS Interventions,
based in Pietermaritzburg, South Africa. The program uses soccer networks to raise awareness about HIV
transmission, safer sex and issues such as stigma and discrimination. Photo: Paul Weinberg/OxfamAUS.
14 15
3.6. Bela Bela HIV and AIDS
prevention group in Limpopo
province, South Africa
Purpose and origins of organisation
The Bela Bela HIV and AIDS Prevention
Group aims to support people infected and
affected by HIV and AIDS by providing
antiretroviral treatment and facilitating
home-based care, support groups, orphan
care, prevention work, treatment literacy,
voluntary counselling and testing, follow-up
counselling, training and antiretroviral
treatment support. Benefciaries are
community members who are infected and
affected by HIV and AIDS, patients who are
on an antiretroviral treatment program, and
community groups, especially young people
at local primary and secondary schools,
who receive prevention messages.
APAC supports work in Spapark suburb
and Vingerkraal village. The intervention in
Spapark grew out of individual counselling
by church members. When antiretroviral
treatment became available, the community
asked for information. Volunteers, chosen
at a community meeting, formed a support
group. They work for a year as trainees in
return for breakfast, lunch and food parcels.
After a year, their performance, commitment
and skills are evaluated and successful
volunteers qualify for a stipend. Volunteers
are self-motivated, and focus on door-to-door
visits to create awareness in the households.
Benefciaries attend support groups at the
clinic, where they also receive treatment if
necessary and support groups have been
approached by farm workers and farmers
seeking assistance.
Vingerkraal village was established in
1992 by Namibian refugees who had been
demobilised from the South African Defence
Force and were not welcome in their home
communities due to their involvement in the
war. About 1,000 men bought a farm with
their pension pay outs and their families
grew to a village of about 3,200 people.
Vingerkraal is a remote village without water,
electricity, transport or other services and
most men are working in cities as security
guards or in Afghanistan.
Again, the intervention grew out of
individual counselling by church members.
The community asked for help in 2003
when nearly a third of the population had
died. A health specialist assessed the
situation, advised the community leaders,
and encouraged the frst patients to consult
the doctor. By 2004 enough patients had
completed voluntary counselling and
testing, and the community asked for help
with treatment. The awareness campaign
began in 2005, with the children translating
during door-to-door visits to homes.
In Vingerkraal, the need and motivation
were so great that, unusually, treatment
started before the awareness program. The
community invited Bela Bela to conduct
an awareness program and home visits
were conducted in the village. This helped
to reduce stigma, and the support among
community members resulted in good
compliance with the antiretroviral treatment
regime. The church donates food parcels
to orphans and vulnerable children and
many patients receive disability grants. The
community is mobilising for water to enable
the establishment of food gardens.
The Bela Bela selection committee decides
on eligibility for treatment and the nurse,
counsellor and caregiver visit the patients
home to observe the openness of the family.
The patient and a treatment supporter
from the family must complete the
three-day adherence training and
counselling and understand the support
commitment. The patient signs a treatment
contract with the clinic, joins the support
group, keeps daily treatment records
and visits the clinic monthly for testing,
medication, counselling and to present
treatment records. Poor compliance is dealt
with quickly and forcefully by nurses, doctors,
counsellors, and volunteers to prevent the
development of wild virus untreatable
forms of the virus caused by mutation.
Community engagement strategy
The community engagement strategy
varies depending on the circumstances.
Generally, community engagement relies
on the openness of infected people who
are prepared to share their experiences
in public testimonies and groundwork with
community leaders and with churches and
schools. The process starts with awareness
and door-to-door visits by community leaders
and volunteers. Later, at a community
meeting where a well known person shares
their testimony, a support group forms.
The support group takes over the awareness
visits, and starts home-based care, orphan
care, voluntary counselling and testing
and treatment support.
Challenges and strengths
Challenges include the high cost of
medication, the need for more support
by the Department of Health at provincial
level and insuffcient funds for stipends
for all volunteers.
Successful outcomes of the project include
good compliance with the antiretroviral
treatment regime. This is attributed to the
adherence training for patients and their
treatment supporter, combined with help
from the support group, a contract with
the clinic, home visits and openness in the
family. Another positive outcome of the
project is that orphans are attending school
and employed patients are back at work. In
addition, volunteers are self-motivated and
drive prevention and mitigation initiatives.
The community
asked for help in
2003 when nearly
a third of the
population had died.
By 2004 enough
patients had
completed voluntary
counselling and
testing, and the
community asked for
help with treatment.
The awareness
campaign began
in 2005, with the
children translating
during door-to-door
visits to homes.
Sophie Maeokela, an activist with Bela Bela HIV and AIDS Prevention Group, in South Africa, visits
a school to raise awareness about HIV and AIDS. Photo: Paul Weinberg/OxfamAUS.
16 17
Community engagement strategy
The frst contact is with traditional leaders
and CHoiCe then addresses a community
meeting to explain the health intervention.
The community elects potential volunteers
or, occasionally, volunteers present
themselves to CHoiCe. The volunteers are
screened using set criteria and an interview
process to minimise drop-outs. Successful
volunteers are re-introduced as CHoiCe
volunteers at a community meeting. Over
the next two years, all caregivers complete
the home-based care national curriculum
alongside their duties as caregivers.
Community work is built on formal training
for volunteers, home visits and regular
support group meetings for volunteers and
benefciary groups. The purpose of support
groups is to discuss challenges, solutions
and successes, build relationships, and
share information through health talks
by trained staff and volunteers. The 250
volunteers work in their home villages, with
a team leader at each of the 30 clinics,
supported by a volunteer coordinator in each
area. CHoiCe staff provide technical support
and mentorship.
Each volunteer conducts home visits that
focus on door-to-door health education.
Volunteers identify vulnerable or sick people,
build relationships, provide confdential
counselling that breaks through stigma and
discrimination and encourage patients to
consult the clinic and seek and adhere to
treatment. Vulnerable people and patients
are encouraged to join support groups.
The referral system brings in professionals,
including social workers, physiotherapists,
counsellors, tuberculosis coordinators,
nurses, social workers, health inspectors,
police and speech and hearing therapists
to help specifc families and patients.
Challenges and strengths
One of the challenges CHoiCe faces is
the gap left when skilled volunteers leave
the program for alternative employment.
CHoiCe received stipends for only half the
volunteers last year after the government
introduced stipends for volunteers. Different
organisations apply different qualifcation
criteria and performance and quality
standards to volunteers receiving the
same stipend. Actual competition between
volunteers from different organisations for
patients was a challenge, but has been
partially resolved as clinic staff allocate
each patient to a volunteer based on
geographical areas.
Strengths of the CHoiCe project include
the Services Sector Education and Training
Authority (SETA) accredited training which,
together with work experience, equips
volunteer caregivers for employment.
CHoiCe initiatives are well planned and
monitored and new initiatives are regularly
identifed, researched, designed and
rolled out. Volunteers work with a large
number of stakeholders in all categories
including benefciaries, community leaders,
professionals, and other volunteers through
support groups and referral networks.
Initiatives are inclusive and aim to support
children and youth, patients, caregivers
and families.
The purpose of support groups is to discuss
challenges, solutions and successes, build
relationships, and share information through
health talks by trained staff and volunteers.
CHoiCe volunteers visit local villages in the Greater Tzaneen area, in South Africas Limpopo province and speak
about HIV and AIDS. Here they hold an open forum in Mamitwa town where pedestrians ask questions pertaining
to HIV and AIDS and the stigmas attached. Photo: Matthew Willman/OxfamAUS.
3.7. CHoiCe Comprehensive Health
Care Trust in Limpopo province,
South Africa
Purpose and origins of organisation
CHoiCe aims to improve the health of people
living in the Greater Tzaneen Municipality by
mobilising community volunteers who, once
trained as community home-based caregivers,
visit homes to educate, train, support, counsel
and serve households to improve their health.
Caregivers identify other needs through home
visits, and have established:
support groups for people living with
HIV and AIDS, chronic patients, caregivers
and grannies
scout and cub groups for vulnerable
children, orphans and young people
vegetable gardens at homes and clinics
to generate food and income
a support system for home community
based caregivers which includes debriefng,
networking, rewards, training, mentorship
and referrals
accredited, certifed training courses to
build the skills and capacity of care givers,
benefciaries and community members who
can build a quality local support system
a methodology to build circles of support
around orphans and vulnerable children
through training community members and
group therapy
and a storytelling program to create
awareness. The interventions are built on the
belief that CHoiCe is about being healthy.
4. Summary
The aim of the APAC program is to
contribute to the building of Southern African
communities to lead their own development,
tackle the impacts of HIV and AIDS and to
have increased food security and access to
basic social services. This research study
suggests that there is no single community
development approach that can do this;
rather that practice on the ground remains
dynamic, fexible and responsive to the
changing needs, demands and challenges
of benefciaries, community structures,
government service delivery and civil
societys growth. This report has attempted
to highlight a number of the common
approaches, trends in the programs and
communities, and the strengths and
challenges experienced by the partners.
The partner approaches to community
development respond to where the initial
need for the services was identifed and
to the local socio-economic and political
dynamics of the community. No partners
community development approach fts
into a single theoretical approach. What is
common is the organisations human rights
principles and that ownership for community
development rests with capacity building of
community-based initiatives.
Transformation and social learning theory
suggest that learning takes place when
individuals are active participants in the
summary
practices of social communities, and
developmental transformation takes place
through individuals belonging to and
participating in communities gaining a new
identity. The case studies suggest that the
process of social participation is greatly
enhanced through engaging in behaviour
change strategies at the individual,
interpersonal, organisational, community
and society level.
One of the strengths of the APAC partner
approaches is the commitment to ensuring
effective community engagement. The
benefciaries are involved in the interventions
throughout the stages of the program. The
levels do vary across the organisations and
individual programs depending on where the
need was identifed, existing relationships,
and the community dynamics.
Challenges partners face include working
within the political context of traditional, local
and provincial government as well as the lack
of statistical data from government health
services. This makes it diffcult to measure
the impact of health prevention and treatment
work within a specifc community. There are
inadequate allowances and stipends from
government for community-based volunteers
and organisations have to constantly recruit
new members as experienced volunteers
leave for alternate employment. This results
in the need for constant capacity building.
In Mozambique, the member organisations
and associations also need capacity building
as most were established within the last fve
years. The cost of antiretroviral treatment
has reduced over recent years, but is still
high for families who live in poverty.
The case studies
suggest that the
process of social
participation is
greatly enhanced
through engaging
in behaviour
change strategies
at the individual,
interpersonal,
organisational,
community and
society level.
CHoiCe volunteer Agrineth Mongwe relaxing outside her hut in the Mamitwa village. She is
waiting for the children to arrive for their scout gathering at her house after school. Many of the
Volunteers go beyond their call to involve their lives closely with the community even in using
their own homes for venues to promote their message in the village.
Photo: Matthew Willman/OxfamAUS.
18 19
20 21
Lesson 3: Integrating whole
community development
External support and assistance needs to
be directed by community members towards
building on from what already exists, and
involving community members in actual
implementation. The seven APAC partners
demonstrate various approaches towards
involving community members at different
levels in the project phases. The focus of
all the partners is on building knowledge,
practice and community capacity to make
informed decisions and respond to their own
developmental needs. This requires looking
at the whole community, the relationships
and dynamics that govern and lead the
community, and the role of all individuals,
including the more vulnerable, in overcoming
the challenges. Effective approaches to
overcome the challenges a community faces,
appear to be through mobilising community
members in ownership and action.
lessons
Lesson 4: Build relationships between
state, civil society and community
Community relationships with government
are necessary in the mobilisation of
community resources, and in enabling
communities to access health and
agricultural services. The relationships
between civil society organisations and
government vary and are specifc to the
APAC partner purpose and community
development approach. The strengthening
of these relationships appears to be a critical
element in sustained health and agricultural
services in poor communities.
Lesson 5: Expanding circles of infuence
Sustained transformation and social change
is more likely to occur when an organisation
and its members expand their circle of
infuence through providing interventions
that meet community-agreed needs, and
that open opportunities for individual
members to actively engage in issues that
directly affect them. This approach requires
using social marketing strategies to potential
benefciaries. Methods include door-to-door
campaigns, loud speakers from vehicles,
dramas to share information on health
issues, pictures to stimulate discussion,
role-plays to demonstrate and compare
different behaviour options, peer education
and building on strong choral and oral
cultures. These activities, however, cannot
stand alone; they work if complemented by
interventions that actively support affected
and infected people.
Volunteer AIDS peer educators with Centre for Positive Care perform theatre and songs adapted to convey HIV and AIDS awareness messages to people at a rural health centre in
the Thoyandou Valley, Limpopo Province, South Africa. Photo: Paul Weinberg/OxfamAUS.
5. Lessons
A number of key lessons that inform
community development practice in the
region emerge from this research.
Lesson 1: Protocols and fow for
community entry and engagement
The community entry approaches
implemented by the fve South African
partners were dependent on how the project
emerged. The approaches included requests
from community leadership to enter into a
partnership with the community by providing
skills to build capacity for community
members to meet identifed needs. In other
situations, the partner had to raise public
awareness and arrange meetings with
local leadership to enable them to
enter a community.
The experience of the APAC partners
highlights the importance of establishing
working relationships with traditional leaders
who are instrumental in mobilising resources
within a community, facilitating community
member participation, and in sustaining
initiatives. Without their support, the
project is unlikely to succeed. This requires
understanding the protocols for engaging
with traditional leaders and ensuring that
they are followed from the earliest stage of
possible engagement.
Community engagement is a continuous
process, and requires working in
partnership with government, traditional
leaders, civil society organisations and
individual community members. Through
this engagement, transformation and
social learning is more likely to become
a reality and to be sustained beyond the
partner intervention. Initiatives grow out of
the skills and passion of individuals in the
communities; successful initiatives roll out
quickly across a community with passionate
staff and volunteers, close relationships
between role players and stakeholders, and
a clear strategy based on sound principles of
governance and community ownership.
Lesson 2: Capacity building
for good governance
The two Mozambique partners clearly
demonstrate the necessity for building
good governance at all levels of a network
or union movement, particularly given
the recent establishment of many of the
associations. This requires structuring
the network, capacity building and
demonstrating good governance through
the organisational work. All activities, in all
seven APAC partners, contribute towards
capacity building and learning of the
collective community enterprise.
The experience of the APAC partners
highlights the importance of establishing
working relationships with traditional leaders
who are instrumental in mobilising resources
within a community, facilitating community
member participation, and in sustaining
initiatives. Without their support, the
project is unlikely to succeed.
conclusion
6. Conclusion
This report explores the community
engagement strategies of the seven partners
in Mozambique and South Africa in relation
to how partner organisations enter and
engage with communities, and approach
community development.
The strengths and challenges highlighted
in this review are not specifc to the APAC
partners or the focus areas; they are largely
factors that NGOs face in Mozambique and
South Africa. There is often a contention
between civil society and state and one of
the challenges NGOs face is the constant
need to mediate this dynamic relationship.
The role of the seven APAC partners is
to build capacity and open opportunities
to enable communities to lead their own
development within the highly politicised
nature of historical development challenges
in both countries. This clearly shapes the
principles and approaches of organisations
within the countries and informs the nature
of relationships between state, civil society
organisations and community members.
This page: Volunteers from CPCs peer educators
project meet in large to discuss future plans and
activities and to camaraderie and a sense of team
work. Photo: Matthew Willman/OxfamAUS.
Back cover: Carers from Oxfams partner CHoiCE
head home at the end of a day carrying out community
visits to people living with HIV and AIDS. Over 240
volunteers and about 12 staff members provide HIV
and AIDS training, care and support, information and
health services based to people living with HIV and
AIDS, their families, orphans and vulnerable children.
Photo: Matthew Willman/OxfamAUS.
22 23
ISBN 978-1-875870-63-9
The Australian Partnerships With African Communities (APAC) Program, funded by AusAID (cooperative agreement 09790/11)
for a period of ve years, was implemented, through Oxfam Australia and its partners in 2004 in Mozambique and South Africa.
Its overall goal is to enhance effective responses to HIV and AIDS and increase sustainable food security in the communities
within which Oxfam Australias partner organisations work.