Faith-based Responses TO HIV/AIDS IN South Africa

Excerpts from the document

HIV/AIDS strategies in South Africa have generally emphasised the role of the formal health system, led by national and provincial governments, in providing support to areas such as condom distribution, the treatment of sexually transmitted infections (STIs), voluntary counselling and testing (VCT), prevention of mother-to-child transmission (PMTCT), treatment of opportunistic infections and, the provision of antiretroviral drugs (ARVs).

Less attention has been paid to documenting and analysing the many and diverse activities conducted by non-governmental organisations, community-based organisations and other institutions, including faith-based organisations, at community level. These organisations provide a range of HIV/AIDS-related services across the continuum of prevention, care and support, treatment and rights. Much however remains to be understood about the nature, scale and scope of these contributions and the way in which they supplement and interface with more centralised responses.

By early 2005, more than 2000 organisations and groups had been entered into the National AIDS Database (www.hivan.org.za/aidsdatasearchadvance.asp) and entries for organisations continue to be added to the database as they are received. In October 2004 a collaboration between CADRE and HIVAN was initiated to analyse the contents of the National AIDS Database with a view to better understanding HIV/AIDS response in South Africa, including the growth of the non-governmental sector, organisational capacities, absorptive capacities for funding, service areas, duplication and gaps, collaboration and reach.

This report presents selected findings from this research, focusing on the activities of the faith-based organisations listed in the database as of October 2004. An examination of the contents of the South African National AIDS Database shows that faith-based organisations are a significant actor within the South African AIDS response.

Approximately 10% of the organisations listed in the database classify themselves as faith-based. These include diverse institutional types, ranging from national and diocese level religious structures to small-scale projects run by religious groups at community level. The database includes entries from social service and outreach agencies affiliated to religious denominations, ecumenical networks of religious groups concerned with HIV/AIDS, and faith-based non-governmental organisations working in a variety of fields.

The FBOs in the database are predominantly Christian. Nearly half the FBOs in the dataset represent projects that are either administered by religious groups or are privately-run, but with a faith orientation. Along with church-run social service agencies and congregations, these projects administer a variety of HIV/AIDS-related services at community level and have therefore been chosen as the focus of the analysis.

This analysis adds to a small, but growing body of evidence about the contributions made by faith-based organisations to HIV/AIDS response. It suggests that:

• Faith-based organisations of different types and profiles are involved with multiple aspects of AIDS response in South Africa, with a particular focus HIV prevention and care services;
• The activities carried out by many of these FBOs are fairly limited in reach, occur close to the ground¡¦ in community settings, and do not appear to be integrated into larger service-delivery frameworks;
• The resourcing of FBO activity is heavily dependent upon donations, although other sources of funding are accessed to a limited extent by some FBOs; and
• There appear to be differences in the number, scope and focus of FBO-led AIDS response activities in urban and rural settings. Rural organisations appear to be less well resourced, less independent (as evidenced by higher levels of networking), and more closely connected to people and communities.

Analysis of this sort, while useful in pointing to the big picture is unable to answer many underlying questions that relate to the manner in which FBOs are working, the motivations which underpin their responses, and the impact of their activities. Some of the questions that need to be further investigated, with the help of qualitative research methodologies, include:

• How do FBOs determine their programme focus?
• How do they plan their work? On the basis of what types of needs assessments, with what degree of guidance, and using what types of overarching ideas and frameworks?
• How do they monitor and evaluate their work?
• How integrated are FBO activities with those of their denominations and mother bodies?
• To what extent are FBOs involved with ecumenical or interfaith AIDS responses?
• What types of relationships exist between FBOs and secular organisations also involved with AIDS-related activity?