[procaare] Reaching Out, Scaling Up: Track A Report

[ProCAARE <procaare@usa.healthnet.org>]

Reaching Out, Scaling Up: Track A Report
- SA HCBC Conference, Rustenberg
********************

[Moderators Note: The SA HCBC was a great success.Three hundred and sixty people attended
this exciting conference, the first of its kind in South Africa. The Track Reports and
interim conference recommendations will be posted in the next few days.]

Track A Report

Presented by: Gustav Wilson: Track Chair

* Introduction
- Challenges acknowledged objectively
- Unwavering commitment to action

* Context of HCBC discussed in Track A
- Stigma and discrimination
- Enabling and empowering environment
- Socio-economic rights
- Policies and management.

* Conference objectives
- Exchange of lessons learnt re strategies to improve the quality of life & reduce burden
of illness
- Identification & analysis of all factors that promote or threaten sustainability of HCBC
- Advocating for greater involvement of People Living with HIV/AIDS.

* Cross cutting issues
-HCBC is a sustainable strategy
- Lack of co-ordination between initiatives is debilitating
- Current initiatives need to be evaluated objectively
- Stigma & discrimination is a barrier
- Internalised stigmatisation only addressed through encouragement to speak out
- Socio-economic issues must be addressed
- Socio-economic context of care determines nature of care
- Focus of care should also be extended to the children of terminally ill parent(s).

* Lessons learnt
- Prevalence of HIV/AIDS higher in some regions due to variety of socio-economic
conditions
- HIV/AIDS & TB should not be seen as separate - treatment should be complementary
- VCT entry point for HCBC where integrated services are provided
- Transparent evaluation of HCBC crucial
- Best practice models should be replicated
- Holistic approaches to HCBC have proven more effective
- Normalisation of HIV/AIDS vital to reduce stigma & discrimination.

* People infected and affected need to be involved in planning process of services
- Inability to provide policies to fast track funds to projects impacts negatively on
service delivery
- Lessons learnt to be translated into tangible action - context of HCBC must be enabling.

* Outputs from group discussions

# Stigma & Discrimination:
- Widespread across communities
- Stumbling block to interventions
- Increases impact of HIV/AIDS on society
- Occurs in many contexts:
Family;
Local community;
Schools;
Faith based communities; and
Workplace.

# Some causes of stigma & discrimination:
- Lack of understanding about HIV/AIDS;
- Myths about the transmission of HIV/AIDS;
- Lack of available treatment;
- Fear of death;
- Portrayal in media as incurable.
- Roots of stigma are deep - relate to issues of culture, class, race and gender.

* HCBC policies and Management:
- Lack of transparency and accountability in resource allocation - ongoing issue
- Lack of communication and coordination between all stakeholders on all levels must be
addressed
- Insufficient monitoring & evaluation and inadequate support & resources for volunteers
- Structures needed to evaluate activities, partnerships and resources.

* Creating an Enabling & Empowering Environment:
- Currently lack of enabling legislation and shortage of resources
- Little integration of HCBC services
- Staff increasingly burdened re service delivery
- Many income generation programmes unsuccessful
- Stigma & discrimination obstacle
- People must be empowered to use their skills to improve quality of life.

* Socio-Economic Issues:
- Poverty greatest obstacle to effective HCBC
- Areas that affect work of HCBC workers:
- Food security; and
- Lack of necessary documentation.
- Integrated response from ALL stakeholders urgently needed to address this situation
- Structures to be set up at local level to ensure speedy delivery to needy families

* Lack of identity documentation leads to difficulties in accessing grants
- A number of rights are therefore violated:
Access to public funding;
Education;
Dignity;
Information; and
Self-reliance.
- Enormous impact on orphans & child-headed households
- Education needed around issue of burying identity documents with the deceased.

Acknowledgements:
Rapporteur team: Bobby Rodwell & Melody Emmett: Sibambene Development Communications
All participants that attended the group discussions in Track A.

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