ALTH O NOM  ICS   ANNUAL REPORT   2011ND  HIVND A IDSE SEA RCH
Influencing global thinking and actionon health and developmentMissionTo inspire health and development strategies, polici...
CONTENTS02	   Foreword04	   From the Executive Director08	   Governing Board10	   HEARD Researchers12	   Research Overview...
01
FOREWORD     Janet Love, National Director, Legal Resource Centre and HEARD Board Chairperson I       welcome the opportun...
“      HEARD’s involvement within the African region                  lays a good foundation for improved health          ...
FROM THE EXECUTIVE DIRECTOR     Professor Alan Whiteside     T              he 2011 Annual Report reflects a year       It...
“     The work of the staff at HEARD (research and                 administrative) must be commended. It is their         ...
Donor meetings are held twice a year         Our work sets out to answer questions            We need to have a vision for...
07                 funded 13 PhD students and we are seeing           Caribbean AIDS conference in the Bahamas.        opp...
GOVERNING BOARD     Staff pictured with the Governing Board (from left to right)     Ms Janet Love                        ...
09
Professor Alan Whiteside          Gavin George                                                                            ...
Andrew Gibbs                                                                             Dr Jill Hanass-Hancock       Ilar...
RESEARCH OVERVIEW     Dr Kaymarlin Govender12
13       “   HEARD’s programme areas enable it to engage           and respond to the complexities of an evolving         ...
H               EARD’s programmatic areas of            violence (GBV) and HIV through a critical               engagement...
relatively easily accepted in some regions          between the construction of masculinities and                of sub-Sa...
little research identifies concrete methods         country’s commitment to responding to the     to build critical consci...
17                           was undertaken, is nearing completion and will                           be piloted in 2012. ...
In 2010 data was collected from a survey     of 2 477 children between the ages of 10-17     years and their adult primary...
Two of these presentations won awards:                  Since 2000/2001 the life orientation                              ...
ACTIVE RESEARCH PROJECTS20
1.	 Addressing the Balance of Burden of AIDS           Research Partners’ Consortium                                      ...
GENDER EQUALITY AND HIV PREVENTION PROGRAMME     Samantha Willan22
23       “   Effectively addressing the intersection between           HIV and AIDS and gender inequalities requires      ...
O                verwhelming evidence exists that         The programme received funding from Sida,            The HIV, ge...
25                                                      throughout 2011 and was piloted with young                        ...
To understand the limited impact that     gender and HIV policies often have on     changing the realities for women and g...
“    In 2010 the team undertook research                and collaboratively developed a                                   ...
RESEARCH CAPACITY PROGRAMME     Samuel Gormley28
29       “   Without additional research in Africa by Africans,           patterns of knowledge dominance will remain     ...
I       n 2008 HEARD launched its JFA-funded       Capacity Building Programme focusing       on creating and building sou...
2.	 Monitoring   and   Evaluation   for                    Complicated and Complex Aspects of                    Programme...
5.	 Workshop on Urban Food Security and         HIV and AIDS in Southern and East         Africa – June 2011     The Afric...
PhD Programme                                                                                        33                   ...
AFRICAN LEADERSHIP PROGRAMME     Samuel Gormley34
35       “   If HEARD is to make a difference in the           response to the AIDS epidemic, leaders           throughout...
T             he African Leadership Programme            Education                                           programme wer...
37               Participants pictured at the regional workshop on HIV, Human Rights and Gender Equality,               ho...
5.	 A study of HIV in slums, commissioned by         UNHABITAT and UNAIDS and conducted         by the MRC, Wits Universit...
to carry out confidential screening activities in      programmes in other sub-sectors such as                these unders...
RESEARCH UTILISATION     Dr Alison Misselhorn40
41       “   Under its Utilisation Strategy, HEARD further           developed a monitoring and evaluation           frame...
D                uring 2011, under its Utilisation                Strategy, HEARD further developed                a monit...
43                Young Carers team members conducting                surveys on the rural field site                 Oper...
the WHO. A presentation made at the South                                                  Under HEARD’s Gender Equality a...
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
HEARD Annual Report 2011
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HEARD Annual Report 2011

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HEARD Annual Report for 2011
- Meet the Board Members, Research and Operations Teams
- Research Capacity Programme
- African Leadership Programme
- Active Research Projects
- Gender Equality and HIV Prevention Programme
- Research Utilisation
- Communications and Marketing
- HEARD's 2011 Research Outputs
- Annual Financial Statements

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HEARD Annual Report 2011

  1. 1. ALTH O NOM ICS ANNUAL REPORT 2011ND HIVND A IDSE SEA RCH
  2. 2. Influencing global thinking and actionon health and developmentMissionTo inspire health and development strategies, policies and practicesthat improve the welfare of people in and beyond Africa.General Objectives• To improve private and public sector understanding of the socio- economic impacts of HIV and AIDS through an applied research focus• To promote multi-sectoral responses to the impact of HIV and AIDS• To develop the practice of health economics and social/behavioural science• To train business and community leaders, professionals and government officials in the strategic planning for the management of HIV and AIDS and other health issues.General Principles• Effective interventions through sound socio-economic, social and behavioural analysis and interdisciplinary research• The transfer of skills• The sharing of knowledge• Capacity building• Research utilisation.HEARD conducts research, builds capacity and enablesleadership to roll back the HIV and AIDS pandemic in Africa.
  3. 3. CONTENTS02 Foreword04 From the Executive Director08 Governing Board10 HEARD Researchers12 Research Overview20 Active Research Projects22 Gender Equality and HIV Prevention Programme28 Research Capacity Programme34 African Leadership Programme40 Research Utilisation48 Research Outputs54 Operations60 Annual Financial Statements79 Acknowledgments80 List of Acronyms
  4. 4. 01
  5. 5. FOREWORD Janet Love, National Director, Legal Resource Centre and HEARD Board Chairperson I welcome the opportunity to convey in this The forthcoming shift of HEARD into introduction my profound admiration for a situation of greater autonomy in relation the work undertaken by the dedicated and to the university administration will add committed group of people that comprises to its flexibility, while its commitment to HEARD. It is an honour to be associated with engaging with professionals working in these endeavours. tertiary institutions, including the University of KwaZulu-Natal (UKZN), remains as strong as As South Africa sets about confronting the ever. This will doubtless continue to secure challenges associated with the reorganisation academic rigour and provide opportunities of health care and the establishment of a for peer review that will ensure the quality health care safety net for all, there can be of HEARD’s research and enhance the no doubt that HEARD is well placed to make dissemination of results. a vital contribution. With its evidence-based work, its experience in community-based Applied research can only become a research and its ability to bring financial reality rather than a paper tiger if networking, resource issues into sharp focus, HEARD outreach and productive engagement with remains a leader in the field. In addition, others in the policy and implementation space the added value that has arisen through - within SA, the region and globally - continues HEARD’s involvement within the African to be fostered. HEARD has demonstrated that region lays a good foundation for improved it has the necessary skills to ensure that such health management, prevention and response interactions are integrated into its work. The initiatives that will positively affect the lives of Annual Report you are about to read provides millions. clear evidence of this.02
  6. 6. “ HEARD’s involvement within the African region lays a good foundation for improved health 03 management, prevention and response initiatives that will positively affect the lives of millions. ” Interventions to tackle chronic and Board join me in expressing our appreciation infectious diseases have seen more progress and our hope that in the years that lie ahead in South Africa over the past few years. The more will be achieved through even greater current political commitment to secure the collaboration. right to access health care for all in our country will greatly benefit from the work that HEARD has carried out. Health challenges are not new; but how we are able to most effectively respond to and prevent illness and disease benefits greatly from the existence of a capacity like HEARD that is set apart from, but strongly connected to, the public health sector. Only through such independence can sufficient critical space come about. Only through such linkage can priorities be properly understood and focused upon. HEARD has succeeded in both senses. To continue to do so, it needs to be able to maintain existing partnerships and to secure new opportunities and resources. The support of our partners and donors is critical and highly valued, and all staff and members of the2011 FOREWORD
  7. 7. FROM THE EXECUTIVE DIRECTOR Professor Alan Whiteside T he 2011 Annual Report reflects a year It was a record year for peer reviewed of intense activity. We wrapped up publications, and many are in high caliber the first Joint Financing Arrangement journals. At the same time the importance of (JFA) and began a new phase in the getting research into the broader community life of the organisation, with somewhat less and policy and practice has remained high core support, but with Swedish Sida and on our agenda. It is a source of pride that Norwegian Regional AIDS Team being our we have a proper utilisation strategy and, most significant partners. Despite the decline although attribution is always a challenge, in funding, research and outputs have been we know that our website is viewed and our outstanding. material downloaded. The innovation of adding a citation index is one that will be useful in the future.04
  8. 8. “ The work of the staff at HEARD (research and administrative) must be commended. It is their 05 hard work and collaborative spirit that makes the organisation run well and productively. ” In 2011 it became apparent the downward There are signs of progress. The number treatment for an HIV infected person would trend in donor funding for HIV was continuing. of people on treatment has skyrocketed. In reduce the risk of HIV transmission to their Between 2009 and 2010 international Botswana it is estimated that 88% of those in regular partner. The results showed this investments for AIDS fell by 13%. Although need are getting drugs. Prevention of mother reduced risk of transmission by about 96%. the drop between 2010 and 2011 may not -to-child transmission has been successfully be as great, this certainly marks a troubling rolled out. There are signs of behaviour Although this is all encouraging, it means development. The challenge is to raise more change, especially among younger people. that the importance of the work we do at domestic funding, but also make better use of HEARD has increased. Now more than ever existing resources. Ironically 2011 also marked The challenges are to ensure those who before we need to understand cost benefit the 30th anniversary of the identification of the need care receive it, but at the same time and cost effectiveness. We were involved disease that was to become known as AIDS. A prevention must remain high on the agenda. with the Rethink HIV initiative of the Rush number of international meetings were held to There are still more people being infected Foundationii. This noted, at a time of dwindling commemorate the date. on a daily basis than are being placed on donor commitment to HIV, a larger share treatment. There have been some significant of funding for programmes will come from Overall southern Africa remains the moves in the area of science, particularly African governments, and set out to help make epicenter of the epidemic. South Africa has promising biomedical responses. Male rational choices. Key are choices specific to the largest number of HIV infected individuals medical circumcision provides protection for country circumstances around prioritisation in the world, an estimated 5.6 million people. uninfected men; a circumcised man is 66% of expenditure on HIV programmes within The unenviable position of the highest HIV less likely to be infected than an uncircumcised budgets; and prioritisation of spending prevalence is held by Swaziland, a country man. The development of microbicides is within programmes. All this is grist to the with which HEARD has developed close links shown to reduce transmission by 39%, and mill of economists, and should be critical for over the past decades. Here the adult (15 – confirmatory trials are underway. In July 2011 policy makers at times of, at best, flat-lined 49) prevalence stood at 25.9%. It was 24.8% the International AIDS Society Pathogenesis resources. in Botswana, 23.6% in Lesotho and 17.8% in Conference in Rome learnt of the HPTN South Africa.i 052 study which asked if early antiretroviral i. www.unaids.org/documents/20101123_GlobalReport_Annexes1_em.pdf2011 FROM THE EXECUTIVE DIRECTOR ii. www.rethinkhiv.com
  9. 9. Donor meetings are held twice a year Our work sets out to answer questions We need to have a vision for the future. years ahead. These include the growing around the drivers of the epidemic, and the In 2011 we pondered, through a number of urbanisation of the continent; the importance gender programme is particularly important one day meetings, namely: The importance of long term care including chronic illness here. We want to help with interventions and of communications at a colloquium ‘30 Years (which thankfully includes HIV when people the male circumcision and Young Carers into the Epidemic: Communicating Health and are put on treatment); and health systems, projects are just two examples of activities HIV Research’; an urbanisation, food security as, at the end of the day, health care must be in this area. Our involvement through the and HIV/AIDS consultation with Queen’s delivered to the people who need it. USAID-supported project with the South University (Canada); and the role of slums. African Department of Basic Education in While developing strategy and planning work Before ending this message we should developing an integrated strategy on HIV, STIs takes time and change is a slow process, note the importance we place on capacity and TB provides an example of links between I would identify a number of areas where I development both within HEARD and research and policy. would like to see additional emphasis in the more broadly. In the 2006 – 2010 JFA we06
  10. 10. 07 funded 13 PhD students and we are seeing Caribbean AIDS conference in the Bahamas. opportunity to thank the Board and the various them graduate. Staff benefit from training I was asked to talk on lessons the Caribbean levels of management at UKZN. The support and mentoring. The internship and junior could learn from southern African. Perhaps of all is much appreciated and we know that researcher programmes are recruiting and the most important one is to ensure their our activities and outputs are valued. graduating, admittedly small numbers, of prevention efforts keep HIV prevalence levels bright young people from across southern and low. eastern Africa. The work of the staff at HEARD (research On a personal note, 2011 was extremely and administrative) must be commended. busy, with a great deal of travel. The trip that It is their hard work and collaborative spirit caused the most envy within HEARD was that makes the organisation run well and the invitation to be a key note speaker at the productively. I would also like to take this2011 FROM THE EXECUTIVE DIRECTOR
  11. 11. GOVERNING BOARD Staff pictured with the Governing Board (from left to right) Ms Janet Love Mr Leonard Okello National Director of the Legal Resource International Head of HIV/AIDS at ActionAid Centre Dr Kaymarlin Govender Mr Samuel Gormely HEARD Research Director HEARD Operations Director Professor Lesley Stainbank Dr Mbulawa Mugabe Dean of the Faculty of Management Studies, Deputy Regional Director of the UNAIDS University of KwaZulu-Natal Regional Support Team for Eastern and Southern Africa Dr Kelvin Storey Director of the Regional AIDS Training Professor Alan Whiteside Network HEARD Executive Director Professor Nelson Ijumba Deputy Vice-Chancellor (Research), University of KwaZulu-Natal08
  12. 12. 09
  13. 13. Professor Alan Whiteside Gavin George Samantha Willan Executive Director Senior Researcher Dr Kaymarlin Govender Dr Jaqualine Mangoma Programme Manager DEcon, University of Natal MComm, University of Natal Research Director (Feb. 2011) Postdoctoral Research Fellow MA, University of KwaZulu-Natal Economic impact of HIV prevention and treatment, DLitt et Phil, University of South Africa PhD, University of Cape Town Gender equality and HIV diseases, HIV and AIDS private sector health strategies, Psycho-social and behavioural Gender equality, HIV and AIDS, prevention, research, policy and development, health health worker migration, HIV issues related to sexuality, HIV medical anthropology and and programme influencing, systems, development and AIDS education strategy and AIDS among adolescents and anthropology of development. training, facilitating, strategic in Swaziland, southern and research. children. thinking and capacity building. African development. Not pictured: Given Mutinta Marisa Casale Staff contracted until December 2011 Junior Researcher Researcher Kerisha Naidoo Managa Pillay: Programme Manager MA, University of Zambia, Doctoral MDev, University of Padua, Doctoral Candidate, University of KwaZulu-Natal Research Intern Candidate, University of Cape Town Dipuo Mde: Senior Grants Manager MSocSci, University of KwaZulu-Natal Communication for public health. HIV youth prevention, social Sinikiwe Sithole: HIV/AIDS Programme Officer HIV prevention, adolescents, support, child and caregiver health. Natashya Pillay: Research Intern monitoring and evaluation.10
  14. 14. Andrew Gibbs Dr Jill Hanass-Hancock Ilaria Regondi Researcher Shaneel Bachoo Researcher Dr Alison Misselhorn Researcher MSc, London School of Economics Project Co-ordinator PhD, Humboldt University Senior Researcher MA, Johns Hopkins and Political Science, Doctoral MSSc, University of KwaZulu-Natal Sexuality education, HIV PhD, University of University Candidate, University of KwaZulu-Natal and AIDS intervention Witwatersrand Health promotion and public Health policy and Social contexts of community health, youth risk, personality evaluations, policy Research and analysis in economics, social mobilisation, gender equality and and risk behaviour, resilience development, disability the areas of vulnerability, protection and urban HIV prevention, media and health research. studies, filmmaking for food security and 11 health. promotion. advocacy purposes. sustainable livelihoods. Candice Jimmyns Candice Reardon Mildred Mushinga Research Intern Junior Researcher Research Intern Leigh Adams Tucker MSocSci, University of KwaZulu-Natal MSocSci, University of KwaZulu-Natal MA, University of Leeds, MSc, Research Assistant University of Zimbabwe HIV and AIDS and sex education in schools. HIV and AIDS and sex education, MSocSci, University of KwaZulu-Natal. masculinity, health systems. Gender and development, HIV and AIDS, Clinical psychology, masculinity and sexuality, masculinities, gender-based violence. identity development.2011 RESEARCHERS
  15. 15. RESEARCH OVERVIEW Dr Kaymarlin Govender12
  16. 16. 13 “ HEARD’s programme areas enable it to engage and respond to the complexities of an evolving HIV epidemic which is marked by variation within countries and even within regions. ”2011
  17. 17. H EARD’s programmatic areas of violence (GBV) and HIV through a critical engagement in the 2011-2015 consciousness raising approach. research strategy are located in three areas: Prevention and Social MMC has been hailed as a key HIV Mobilisation; Health Systems and Health prevention strategy following evidence and Care Access; and Health and HIV in an provided by three randomised control trials Urban Context. These programme areas (RCTs), namely, Orange Farm, South Africa; enable HEARD to engage and respond to Rakai, Uganda; and Kisumu, Kenya. The the complexities of an evolving HIV epidemic widely-cited RCTs found that MMC reduced which is marked by variation within countries the acquisition of HIV in men by between 38 and even within regions. In this 2011 Annual and 66% over 24 months, with low incidence of Report, we focus on the development and adverse events (Siegfried, Muller et al. 2009). progress of specific research activities, The World Health Organization (WHO) and the namely, male circumcision, gender equality Joint United Nations Program on HIV/AIDS and livelihoods, disability-based research and (UNAIDS) endorsed the practice in March policy work, community care, support and 2007 (WHO 2007). As part of this process, 13 the school-based life orientation programme. eastern and southern African countries were These research activities fall within one or identified as priority countries for circumcision more of the programmatic areas stated above. scale-up. While MMC is seen as an effective prevention strategy, sexual risk compensation in relation to male circumcision is still largely Male Circumcision, Gender Equality and unknown and needs to be further researched. Livelihoods In this regard, HEARD is currently partnering with the Centre for the AIDS Programme of Two major research projects were Research in South Africa (CAPRISA), UKZN, conceptualised in 2011 and are presently to undertake a study that examines the issue commencing field work activities. Both of risk compensation in an adolescent cohort projects, which are situated in relation to in the high HIV prevalence site of Vulindlela in interventionist-based research, are integrally KZN. Through tracking a cohort of adolescents related to an effective and sustainable post circumcision, we intend to document response to the HIV epidemic. The medical sexual practice as well as issues broadly male circumcision (MMC) project is focused on related to constructions of masculine and the issue of evaluating a medical intervention, feminine sexualities in this community. This while research on gender is concerned study will have implications for how we should with: a) integrating a livelihoods component consider scale-up of MMC, and more generally within a gender-based intervention, and b) ‘treatment as prevention’ programmes in the exploring models to reduce gender-based region. We note that while MMC has been14
  18. 18. relatively easily accepted in some regions between the construction of masculinities and of sub-Saharan Africa, there is a growing femininities and livelihood insecurity. Further, disquiet among social scientists regarding interventions that do attempt to address 15 the effectiveness of ‘stand alone’ and vertical this issue have not effectively targeted prevention approaches. In terms of progress, young women and men out of school. It is we are in the process of completing the pilot acknowledged that while recent research has phase of the study. The first phase of the identified how gender inequalities intersect study will provide us with valuable knowledge with changing and insecure livelihoods which, related to the contextual dynamics of the study via various processes, are critical for driving population and necessary information in order HIV transmission, this area of work is still in to optimise the scientific design. The main need of substantive research, especially in the study will commence in April 2012 and aims to form of theoretically guided and sustainable provide some answers on the issue of sexual interventions. we think about challenging gender norms that risk compensation in a young, school going go beyond the small group process. population. The HIV, gender inequalities and livelihoods intervention programme led by Further, this project hopes to contribute In recent years, we have noted HEARD researchers in collaboration with the to a body of research on how the working that behavioural interventions, without Medical Research Council Gender and Health practices of young people, through the consideration of broader social and cultural Unit and Project Empower, aims to adapt a distortion of social and cultural practices as dynamics, have only been able to demonstrate previously tested gender-based intervention to a result of rampant HIV and AIDS, impacts improvements in HIV-related knowledge, include a livelihoods strengthening component on their gendered identities. The project also attitudes and behaviours. None of these and evaluate this adapted intervention on hopes to conceptualise and validate pathways interventions have translated into reductions in young people’s sexual risk behaviours and to encourage people to critically think about HIV incidence. Reviews of studies employing other relevant outcomes, in urban South Africa. the barriers they face in constructing stronger behavioural HIV prevention interventions point This project is premised on the notion that livelihoods and, in the longer term, mitigate the to some major deficits in these approaches. gender inequalities and livelihood insecurity impact of the HIV epidemic. Firstly, tackling gender inequalities needs intertwine in multiple ways to limit people’s to be central to behavioural HIV prevention agency to act in new ways, undermine Central to efforts to promoting activities interventions. Secondly, interventions need to people’s confidence and sustain behaviours that question, destabilise and even challenge move beyond small group processes to tackle that have negative impacts on their health and gender norms (a structural driver of the the wider social contexts that limit men’s and wellbeing, as well as being critical as ‘drivers’ HIV epidemic), the development of critical women’s abilities to take control of their sexual of HIV. Importantly, the conceptualisation of consciousness methods is seen as a key health. livelihoods emphasises that people maintain approach to promoting change towards their livelihoods by drawing on a range of more health-enabling norms. While we Thirdly, current interventions that seek resources or capitals: financial, human, social, note that increasing levels of dialogue in to address ‘gender’ as a structural driver, physical and natural. The outcome of this communities about issues affecting structural do not adequately conceptualise the links intervention broadly has implications for how change for health is a key priority, relatively2011 RESEARCH OVERVIEW
  19. 19. little research identifies concrete methods country’s commitment to responding to the to build critical consciousness in poorly HIV epidemic, yet a recent systematic review resourced communities. The GBV and HIV of NSPs in 18 southern and east African intervention research project, a partnership countries revealed that only half recognise with Queen’s University, Canada, intends to disability as an issue and only one country explore effective models to reduce GBV and has taken extended steps to address this HIV in the Sisonke district, KZN. We assert issue. Research established that people living that through dialogue in safe social spaces, with disabilities (PWD) are at increased risk technical information (about HIV, condoms and of exposure to HIV as they are more likely to so forth) can be translated and made real for be victims of sexual violence and exploitation, those who are the targets of such information. have less access to health services and More widely, participatory approaches that education and are more likely to be poor. encourage dialogue provide spaces that allow HEARD, in partnership with Global Contact people to reflect on and reconsider the social Group on AIDS and Disability (GCGAD), relationships in which they are embedded. UNAIDS task group on NSP development and Within these reflexive spaces, people can the International Disability and Development begin to imagine alternative possibilities in Consortium (IDDC) launched a framework relationships between people. Narrative-based for the inclusion of disability into the NSPs methods such as Forum Theatre will be used at the 2011 International Conference on to build forms of critical consciousness at both AIDS and STIs in Africa (ICASA). UNAIDS, individual and collective levels to stimulate as well as other organisations, will use the collective action to change the context of HIV disability framework to guide and review risk. NSP development. It is also envisioned that this framework will be piloted in 2012 in two In 2011, in terms of HEARD’s policy- different settings in order to provide guidelines influencing work, a conceptual framework in terms of how the framework can be was developed on how to include disability implemented in practice. within the National Strategic Plan (NSP) on HIV and AIDS structures and programmes. Disability research also focused efforts The foundational work for disability policy was on the psychologically disabling effects of developed in the last funding cycle bringing HIV. In 2011, HEARD researchers partnered to fruition the painstaking efforts by HEARD with academics from the Department of researchers in pursing ‘the disability agenda’ in Psychology, UKZN, St Mary’s Hospital and spite of its marginalisation in AIDS prevention, the Human Sciences Reseach Council to treatment and access to care discourses. develop a psychological intervention to reduce The Young Carers Project team depression in HIV positive women. The NSPs are important and reflect a development of an intervention manual which16
  20. 20. 17 was undertaken, is nearing completion and will be piloted in 2012. This project aims to deliver a form of counseling that can be scaled up in resource constrained regions in southern Africa. Community Care, Support and the School Based Life Orientation Programme Research that serves to understand as well as strengthen health systems at a community level is important to HIV prevention, care and support. Two research projects that HEARD has undertaken in recent times focus on health systems functioning at a family and school level. The Young Carers Project, in partnership with Oxford University (UK) and Brown University (USA), is concerned with examining the physical, psycho-social and educational wellbeing of children in AIDS affected regions of South Africa.2011 RESEARCH OVERVIEW
  21. 21. In 2010 data was collected from a survey of 2 477 children between the ages of 10-17 years and their adult primary carers, 4 954 interviews in total. These took place at both a rural and urban site in KZN. Preliminary analysis commenced in 2011, and selected findings have provided some important insights in relation to carers and their families in poverty ravished areas, namely: • HIV and disability: In households where carers have limited ability to perform common activities due to their HIV illness, household poverty and child hunger is higher. Children are also more likely to spend more time on intimate care, health care and housework and less likely to attend school. • Parenting and child risk behaviour: Poor parental supervision is associated with children’s sexual activity and engagement in transactional sexual exploitation. • Carer illness and risk of TB infection among children: Children with AIDS, and sick and TB infected carers are at heightened risk for concurrent infectious disease and TB infection. Research from The Young Carers Project resulted in the production of a number of academic presentations during 2011. Thirteen presentations, based on or including the KZN data and experience, were given at regional and international AIDS and/or mental health conferences.18
  22. 22. Two of these presentations won awards: Since 2000/2001 the life orientation programme has become the primary vehicle 1. 2011: 5th South African AIDS Conference, used by the education system to educate 19 Durban, June. ‘Infectious disease and learners about HIV and AIDS, sex and TB co-occurrence amongst children with sexuality and other relevant life skills. In 2010 AIDS-affected caregivers’. Awarded ‘Best the DBE commissioned HEARD to conduct Paper Clinical Excellence’ Prize. research examining how life orientation is being implemented and engaged with in South 2. 2011: 139th American Public Health African high schools in order to determine Association Meeting, Washington DC, how it can be strengthened in future years. November. ‘Mental Health of Children Qualitative research was undertaken in the Affected by AIDS and their Carers in form of focus groups with Grade 9 and 11 KwaZulu-Natal, South Africa’. Abstract learners as well as in-depth interviews with life accepted for presentation and selected orientation educators, heads of department, as an Honorable Mention for the 2011 NGOs and life orientation subject advisors. Excellence in Abstract Submission on an The findings of our research will be finalised International Topic. in 2012 and released by the DBE in late 2012 or 2013. HEARD’s findings will be used HEARD has also driven a research by the DBE and other stakeholder groups agenda that foregrounds HIV prevention in to strengthen the implementation of the life young people from a systems strengthening orientation curriculum within schools across perspective. In 2011, HEARD provided the country. technical support to the Department of Basic Education (DBE), via a grant from USAID, for the development of a national strategy to Conclusion address HIV and AIDS, other STIs and TB among educators, learners and other staff One foreseeable outcome is that 2012 within South Africa’s education sector. The promises to be a year where research ‘Department of Basic Education Integrated activities are intensified as researchers Strategy on HIV, STIs and TB 2012-2016’ grapple with the practical challenges of field represents the Department’s vision for a five work. Further, studies that were part of the year period and articulates the intentions of the previous funding cycle will be in an intensive Department as it responds to the HIV and TB phase of analysis and write-up in 2012. crisis in South Africa, its impact on educational outcomes and the delivery of quality basic education.2011 RESEARCH OVERVIEW
  23. 23. ACTIVE RESEARCH PROJECTS20
  24. 24. 1. Addressing the Balance of Burden of AIDS Research Partners’ Consortium 21 2. Secretariat for UNAIDS/World Bank Economic Reference Group 3. Workplace Voluntary Counselling and Testing and Antiretroviral Therapy Uptake Project 4. Facilitating Alternative Gender Constructs in Home-Based Care and Child Welfare Programmes in South Africa 13. Sex Education for People with Disabilities 5. Occupational Risks for Extensively Drug 14. Mental Health and Depressions in HIV Resistant Tuberculosis Among Heath Care Positive Women Workers in South Africa 15. Medical Male Circumcision Study 6. Stepping Stones and Livelihoods 16. Forced Sterilisation Study Strengthening Intervention: A Pilot Study 17. Social Support and Carer Health Study: 7. Gender-based Violence - A Two-pronged Young Carers Qualitative Bolt-on Study Service and Community Mobilisation Intervention to Reduce Gender-based 18. Life Orientation Project: Implementation, Violence and HIV Vulnerability in Rural Delivery and Engagement with the Life South Africa Orientation Programme in South African Schools 8. Understanding Gender Policy Failure 19. Investigating Male Students’ Perceptions 9. Young Carers KZN: Ukunakekela Project of the Constructions of Masculinity and 10. IDS and the State Book Project A their Implications for the HIV and AIDS Prevention Intervention Programmes at the 11. Call for Rapid Response Research: Health University of KwaZulu-Natal Worker Salaries and Benefits in Low and Middle Income Countries 20. The Media Coverage, Feasibility and Acceptability of One Month of ‘Safe Sex/ 12. ‘Nathi Singabantu’: An Exploratory Study No Sex’ for Preventing HIV Transmission: of the Experiences of Disablement in An Innovative Response People Living with HIV. The Sepo Study in Zambia – The Experience of People with 21. The SAB Tavern Intervention Programme Disabilities Who Are Also HIV Positive for Men2011
  25. 25. GENDER EQUALITY AND HIV PREVENTION PROGRAMME Samantha Willan22
  26. 26. 23 “ Effectively addressing the intersection between HIV and AIDS and gender inequalities requires that interventions should, at the very least, not reinforce damaging gender and sexual stereotypes, and at the most serve to empower women and challenge these stereotypes. ”2011
  27. 27. O verwhelming evidence exists that The programme received funding from Sida, The HIV, gender inequalities and gender inequalities are a significant Merck & Co, the Canadian Institute for Health livelihoods intervention is a collaboration with driver of the HIV epidemic, and Research (CIHR) and towards the end of the MRC Gender and Health Unit and Project further that the epidemic entrenches the year was awarded a grant from the Joint Empower, led by HEARD. This project began these inequalities. Gender inequalities Gender Fund. with reviewing the literature, meeting with also influence access to and experience key stakeholders and reviewing interventions of treatment, care and support. Effectively that have explored these linkages. Following addressing the intersection between HIV The Research the background research, the team worked and AIDS and gender inequalities requires with the Stepping Stones manual, which that interventions should, at the very least, aims to challenge gender norms and support The Programme focused on three areas of not reinforce damaging gender and sexual women’s empowerment, and developed a research in 2011: An HIV, gender inequalities stereotypes, and at the most serve to empower second manual focused on strengthening and livelihoods intervention; the development women and challenge these stereotypes. livelihoods. The long term aim is to build on of a gender-based violence (GBV) and HIV the successful Stepping Stones methodology intervention; and a study on why UN policies Recognising these realities, in 2011 and content with a complimentary intervention on gender and AIDS often fail. HEARD took the strategic decision to that provides comprehensive livelihood move the work on gender equality and HIV skills. The livelihoods manual was developed prevention, previously under the African Leadership Programme, to a standalone programme. The Gender Equality and HIV Prevention Programme within HEARD bridges a number of HEARD’s core areas of research, policy influence and utilisation. In 2011 the Programme had three key foci: 1. Research on interventions that tackle the intersections between gender equality and HIV prevention 2. Utilising our research, experience and networks to influence the effective inclusion of women, girls and gender equality in National Strategic Plans on HIV and AIDS across eastern and southern Africa 3. Capacity building of young African Young participants workshopping the researchers, particularly through the livelihoods manual during pilot phase internship and post-doctoral scholarship programmes.24
  28. 28. 25 throughout 2011 and was piloted with young people from urban informal settlements before being revised. In 2012 the manual will be further piloted once more before being used, in conjunction with Stepping Stones, with 200 young women and men (100 female, 100 male) from urban informal settlements. The outcomes of this intervention will be comprehensively studied by the team. The GBV and HIV intervention research project received five years of funding from the CIHR in 2011, with the work due to begin in early 2012. This is a five year project based in Sisonke district of KZN. It will use a two- pronged intervention to explore effective models to reduce GBV and HIV in this rural community; the first prong is supporting the enhancement and co-ordination of HIV and GBV services in the area and the second is rolling out community mobilisation using techniques such as Forum Theatre. The project is in partnership with a research team at Queen’s University, Canada, and local NGO partners and local government in the district.2011 GENDER EQUALITY AND HIV PREVENTION PROGRAMME
  29. 29. To understand the limited impact that gender and HIV policies often have on changing the realities for women and girls globally, the Programme undertook a study of the UNAIDS gender policy, ‘Agenda for Accelerated Country Action for Women, Girls, Gender Equality and the Context of HIV’. Reviewing documentation and undertaking key informant interviews globally, the study found that while the Agenda had strong language around women’s rights and gender equality, too often there was a lack of resources placed in implementing the policy and that there was often limited political will to tackle gender inequalities by various actors in the UN system. Positively, the Agenda had created an opportunity for women’s rights to become central to the response to HIV and AIDS and gave renewed momentum to this. worked with numerous partners in the region – NGO, governmental and the UN family – to begin transforming NSPs. We co-hosted a Influencing Policy Reform regional workshop in September with UNAIDS, the ATHENA Network and the International A critical aspect of this Programme is HIV/AIDS Alliance, where our work formed a turning research into action, and 2011 was critical aspect of the agenda and analysis; we a key year for focusing on this. In 2010, the also provided technical support (based on our team undertook research and collaboratively framework and findings) to the South African developed a framework on women, girls and women’s sector in drafting the 2012-2016 NSP gender equality in NSPs; in 2011 we utilised and held a ground-breaking regional workshop it widely to ensure meaningful policy changes in the lead-up to ICASA in Addis Ababa in and build leadership among young women December 2011. The workshop brought living with HIV. In collaboration with our together approximately 40 regional players partner, the ATHENA Network, we began by who explored issues around their NSPs and releasing a report, ‘From Talk to Action’, which women’s rights. Many participants reported analysed all NSPs in eastern and southern finding the workshop transformational as they Africa against the framework. Using the had not previously engaged in NSPs and they framework and ‘From Talk to Action’ we then valued the opportunity to learn about both26
  30. 30. “ In 2010 the team undertook research and collaboratively developed a 27 framework on women, girls and gender equality in NSPs; in 2011 we utilised it widely to ensure meaningful policy changes and build leadership among young women living with HIV. ” processes and content for transforming these The Gender Equality and HIV Prevention NSPs. We also produced a policy brief for Programme team comprises Samantha policy makers, NGOs and donors, and towards Willan (programme manager); Andrew the end of the year began developing ‘toolkits’ Gibbs (researcher), Jacqueline Mangoma for easy implementation of the framework. (postdoctoral fellow) and Mildred Mushinga (intern). The Programme is overseen by the Programme Advisory Committee made up of Building African Researchers Rachel Jewkes (director, Gender and Health Research Unit, MRC), Dean Peacock (director, In May 2011, the Programme employed Sonke Gender Justice), Cheryl Potgieter two staff members - an intern and a (Dean of Research, UKZN) and Sipho Mthathi postdoctoral fellow - as part of our objective (South African director, Human Rights Watch). to build the capacity of African researchers. Both have a background in HIV and gender equality. They were supported to be active team members in the projects, build their research and policy skills as well as focus on publishing and disseminating their work at conferences.2011 GENDER EQUALITY AND HIV PREVENTION PROGRAMME
  31. 31. RESEARCH CAPACITY PROGRAMME Samuel Gormley28
  32. 32. 29 “ Without additional research in Africa by Africans, patterns of knowledge dominance will remain and, as importantly, responses by Africans on health and HIV and AIDS issues will lag. ”2011
  33. 33. I n 2008 HEARD launched its JFA-funded Capacity Building Programme focusing on creating and building south-south partnerships and developing the local capacity of Africans who live and work in the South African Development Community (SADC) and east African countries (EAC) region. It remains a reality that most HIV and AIDS research in the SADC and EAC region takes place in South Africa and is characterised by north-south partnerships rather than by south- south or south-south-north partnerships. This has had the effect of extending research Participants pictured after the Systematic opportunities to those for whom they already Review Training exist rather than spreading opportunity to new knowledge-producing agencies. The south to north drain of human capacity in academia is well documented. Without additional research in Africa by Africans, patterns of knowledge investments in HIV capacity building efforts. workshops. Delegates were drawn from dominance will remain and, as importantly, This plan of action has been titled, ‘Scaling across Africa, north America and Europe to responses by Africans on health and HIV and up effective capacity building innovations attend the following events: AIDS issues will lag. for sustainable HIV response in eastern and southern Africa’. 1. Systematic Review Training – March In March 2011, HEARD participated in a and August 2011 Capacity Building Summit in Nairobi which was attended by over 100 organisations from The two day training courses were aimed Capacity Building Events at practioners responsible for implementing across Africa, North America, Europe, Asia and the Far East. The summit took stock of and monitoring health care intervention In 2011, HEARD marketed and ran a programmes. The courses taught progress, achievements and lessons in HIV number of capacity building courses and health practioners and those involved in capacity building, and shared best practices, workshops aimed at educating African leaders implementing and monitoring health care innovations and lessons in critical areas to ensure they are better placed to fight the intervention programmes to better understand affecting capacity building for effective HIV pandemic in Africa. In total, more than 500 the methodology involved in conducting a response in the region. A consensus was delegates, many of whom occupy high level systematic review and to be able to access, reached on a joint plan of action to secure a government and organisational positions, appraise and interpret the results of a medium to long term policy and programme attended HEARD’s training courses and systematic review. that would strengthen and streamline30
  34. 34. 2. Monitoring and Evaluation for Complicated and Complex Aspects of Programmes and Policies Workshop – 31 March 2011 This three day workshop sought to combine both the academic and practical aspects of monitoring and evaluation (M&E) within complicated and complex aspects of programmes and policies. It explored key concepts in M&E and programme theory and assisted participants in understanding programme theory and how to present and implement it. Participants came from a wide array of organisations and fields from across the SADC region, and were able to bring their own expertise, experiences and practical understanding of M&E to the workshop, thus AIDS in transport sectors, covering all modes fostering an environment of joint learning. of transport and defining roles for different stakeholders, were developed. 3. Sub-Regional Workshop on HIV and AIDS in the Transport Sector in 4. Sexuality Education Training – May Southern Africa – March 2011 2011 The International Labor Organization (ILO), the UNESCO, UNICEF, UNFPA and HEARD International Transport Workers’ Federation collaborated to deliver regional sexuality (ITF), UNAIDS and HEARD hosted a sub- education training aimed at reducing HIV regional workshop with the aim of bringing and AIDS, teenage pregnancy, STIs and together diverse stakeholders operating in the gender-based violence in school-going transport sector in the most HIV and AIDS- youth in the SADC region. This training affected regions of southern Africa. The two was aimed at SADC ministries of education day workshop successfully reviewed current and their staff, and UN staff responsible for evidence on HIV, AIDS and TB in the transport youth development in 10 SADC countries. It sector in southern Africa, and identified aimed to increase their knowledge on how to research gaps in order to strengthen evidence. implement effective sexuality education and Existing policies and programmes were also HIV prevention programmes among young reviewed and plans for country and regional people in educational settings. actions in the SADC region, on HIV and2011 RESEARCH CAPACITY PROGRAMME
  35. 35. 5. Workshop on Urban Food Security and HIV and AIDS in Southern and East Africa – June 2011 The African Food Security Urban Network and HEARD partnered to facilitate this workshop in 2011. The workshop brought together researchers, policy-makers and trainers/ facilitators who work in the area of HIV and AIDS and urban food security in southern and eastern Africa. The overall goal was to expand current thinking and challenge the existing frameworks of the relationship between urban food security and HIV and AIDS. 6. Communications Colloquium: ‘30 Years into the Epidemic: Communicating Health and HIV Research’ – June 2011 Attendees from the SADC region, North America and Europe discussed the value of communications in health and HIV research, as well as the necessary goals to enhance the role of communications; the ultimate goal being to mitigate the effects of HIV and AIDS. The colloquium aimed to articulate the intended impacts of communicating health and HIV research, share challenges and lessons learned in communicating health and HIV research, and foster future collaborations to generate strategies and areas of foci for moving forward to achieve desired impacts in communicating health and HIV research.32
  36. 36. PhD Programme 33 During 2011 HEARD’s highly successful PhD Programme continued to support 11 students in their final year of working towards their PhDs. One student, Kisu Simwaka, submitted his dissertation in 2010 and was capped and awarded his PhD at the 2011 UKZN graduation ceremony. A further six of HEARD’s PhD students submitted their dissertations in 2011 and if successful, will be capped at the 2012 graduation ceremony. The real success of this programme is that the students, all drawn from across the SADC and EAC regions, will now continue to work in the region as highly skilled individuals contributing to the fight against the pandemic. HEARD’s PhD Programme is not recruiting new students as further funding is required.2011 RESEARCH CAPACITY PROGRAMME
  37. 37. AFRICAN LEADERSHIP PROGRAMME Samuel Gormley34
  38. 38. 35 “ If HEARD is to make a difference in the response to the AIDS epidemic, leaders throughout southern Africa need to take ownership and be involved. ”2011
  39. 39. T he African Leadership Programme Education programme were highlighted. This contributed (ALP) at HEARD is one of the central to the body of knowledge on effective areas of our activities. If HEARD is programming responses to HIV and sexual Department of Basic Education Draft to make a difference in the response risk amongst youth. Integrated Strategy on HIV and AIDS 2012- to the AIDS epidemic, leaders throughout 2016 HEARD further facilitated the development southern and eastern Africa need to take ownership and be involved. of 10 Geographic Information Systems (GIS) Pursuant to the ALP providing intellectual maps (nine provincial and one national) input into educational programmes in the which mapped the interaction and correlation The ALP aims to do this in three ways: region that aim to educate youth on HIV and between education, HIV and poverty in each AIDS (point 3 above), HEARD consulted with province. These will be used by government 1. By facilitating information sharing with the national Department of Basic Education officials as planning tools for future delivery African leaders and thinkers (DBE) and USAID as part of a cooperative on HIV and AIDS services to schools in 2. By providing a range of training courses agreement to develop the ‘DBE Draft and workshops to develop the skills of Integrated Strategy on HIV and AIDS 2012- African leaders 2016’. 3. By providing the necessary intellectual This new Strategy sets out the basis for a input into educational programmes in the comprehensive and integrated response within region aimed at educating youth on HIV the education system for learners, educators, and AIDS. school support staff and officials, as well as parents and caregivers infected with and The structure of the ALP was altered in affected by HIV and AIDS. 2011 for various reasons. Firstly, we came to the end of a JFA agreement in 2010, and Once again, great effort was expended on thus funding for the new ALP programme was assisting the DBE to draft the Strategy and in reduced. In this regard, a strategic decision the second half of 2011, the DBE approved the was made to downsize some programmes or research component of HEARD’s work on the move them to other programmes. Secondly, project. HEARD’s new research director, Dr Kaymarlin Govender, decided each research programme In broad terms this research project or project would contain an ‘African leadership’ explored how the learning area ‘life orientation’ component. Thirdly, some research focuses is implemented and engaged with in high that in the past were components of schools in order to identify factors that are programmes (namely, Gender and Disability) hindering or enabling the optimal achievement achieved such growth and success they of the programme’s aims. In so doing the justified becoming autonomous areas of salient characteristics associated with research. effective implementation of the life orientation36
  40. 40. 37 Participants pictured at the regional workshop on HIV, Human Rights and Gender Equality, hosted by UNAIDS, HEARD, ATHENA Network and the International HIV/AIDS Alliance the provinces and will enhance sexual and the Gender Programme, the HEARD/ATHENA network of agencies, organisations and reproductive health services to learners, project focusing on integrating women, girls researchers from around the southern educators and school support staff and and gender equality into National Strategic and east African region. Several important officials. Plans on HIV and AIDS across eastern and initiatives have been carried out by partners southern Africa. Her strategic leadership collaborating under the aegis and guidance of African Leadership Research Projects, and knowledge of the UN family, regional the network, including: Workshops and Capacity Building politics and dynamics and her expertise in human rights law and gender added to the 1. A study on the HIV epidemic and Programmes core competencies and unique strength of urbanisation, conducted by the UNAIDS the team. Grant, alongside the programme Regional Support Team The African Leadership Programme works manager of the Gender Equality and HIV with the Gender Programme 2. A review of the HIV responses of 15 cities Prevention Programme, Samantha Willan, was in eastern and southern Africa (ESA), involved in conceptualising and delivering the During 2011, the Gender Equality and commissioned by UNAIDS and conducted regional workshop on HIV, Human Rights and HIV Prevention Programme was fortunate by the MRC, Wits University and HEARD Gender Equality, hosted by UNAIDS, HEARD, to receive input from the ALP. A specialist ATHENA Network and the International HIV/ 3. An epidemiological analysis of the city of consultant, Kitty Grant, was contracted to AIDS Alliance in September 2011. Durban, commissioned by UNAIDS and run the Gender ALP component. Grant has conducted by the consultancy, Maromi over 15 years’ experience in HIV, human Health Research rights and gender equality in southern Africa, Southern and East African Research on working with governments, civil society and 4. A review of the governance aspects of Cities and HIV the UN family. She worked across the two the HIV response in five cities of ESA, programmes, which ensured synergies and commissioned by the United Development HEARD continues to work within the ‘cross-fertilisation’ of ideas, activities and Programme and conducted by OPM Southern and East African Research on Cities networks between the progammes. Grant was consulting and HIV network (SEARCH), a collaborative a core member of one of the projects under2011 AFRICAN LEADERSHIP PROGRAMME
  41. 41. 5. A study of HIV in slums, commissioned by UNHABITAT and UNAIDS and conducted by the MRC, Wits University and HEARD. A written report prepared for UNHABITAT and UNAIDS during 2011 took stock of the evidence available on HIV and cities in the region and drew largely on the above studies to synthesise key findings regarding the relationship between HIV and cities. The report highlighted good practice examples to foster cross-city learning and encourage better programmatic responses. Faith-Based Organisations and Prevention In 2010, the ALP identified faith-based leaders as a key sector that needed to be supported in the fight against the HIV epidemic. HEARD continued its partnership with Bethel Health Builders, a faith-based organisation (FBO) that trains local people to become ‘health builders’ on site in rural or peri-urban marginalised communities. They are trained to conduct rapid tests for HIV and AIDS, diabetes, cholesterol and high blood pressure as needed for people who have limited access to health services. Currently, 18 of these health builders are undertaking the full range of health screening and video-based community awareness- A local health builder viewing the informational raising. In 2011 the programme supplied the animated video on a protable DVD player local health builders with portable equipment, screening devices and portable DVD players38
  42. 42. to carry out confidential screening activities in programmes in other sub-sectors such as these underserved villages. Animated videos civil aviation, railways, maritime sector, on HIV testing, stages of infection and ARVs or to effectively engage all stakeholders 39 were created and are used by health builders (different ministries, unions, employers and and other health promoters. The impact on private sector) the community has been substantial; over 3. Prevention efforts in transport are not 200 people learned their HIV positive status in sufficiently cutting-edge with regard to 2011, with many now on ARV treatment. latest thinking on combination prevention. The capacity of the partners has grown to serve the people of Zululand, and other The International Labor Organization communities in KwaZulu-Natal. (ILO), the International Transport Workers’ Federation, UNAIDS and HEARD came together for a sub-regional workshop in Sub-Regional Workshop on HIV and AIDS Johannesburg during March 2011. in the Transport Sector in Southern Africa The workshop’s aim was to bring together Transportation is integral to development diverse stakeholders operating in the transport in southern Africa. At a macro-economic level, sector in the most HIV and AIDS affected countries’ ability to import and export goods regions of southern Africa including but not and move economic inputs and outputs is limited to transport ministries, national AIDS a key element of GDP growth. At a city and councils, civil society, development partners community level, peoples’ ability to move and representatives of the related employers’ and trade crucially affects their income and and workers’ organisations from Botswana, livelihood. At the same time, there is ample Malawi, Mozambique, Namibia, South Africa, evidence that HIV and AIDS is impacting new international standards, the ILO Kenya, Zimbabwe, Zambia and Tanzania. negatively on the transportation sector in the recommendation concerning HIV and AIDS region. While a number of initiatives have tried and the World of Work, 2010 (No.200) The workshop achieved the following to tackle the issue, they are characterised by objectives: 3. Developed a plan for country and several weaknesses: regional actions on HIV and AIDS in 1. Reviewed current evidence on HIV, AIDS transport sectors, covering all modes of 1. There is little attempt to strengthen, and TB in the transport sector in southern transport and defining roles for different verify, share and manage knowledge and Africa as well as identified gaps and stakeholders. evidence on HIV in transport research agendas to strengthen evidence 2. The majority of the interventions in the 2. Reviewed and assessed the status, Please refer to the section on Capacity transport sector have focused on truckers coverage and effectiveness of existing Building for a more comprehensive report on i.e. the road transport sector. Little has policies and programmes in light of the training. been done to scale up the HIV and AIDS2011 AFRICAN LEADERSHIP PROGRAMME
  43. 43. RESEARCH UTILISATION Dr Alison Misselhorn40
  44. 44. 41 “ Under its Utilisation Strategy, HEARD further developed a monitoring and evaluation framework, aiming to strengthen internal systems for gauging the impact of its work. ”2011
  45. 45. D uring 2011, under its Utilisation Strategy, HEARD further developed a monitoring and evaluation (M&E) framework, aiming to strengthen internal systems for gauging the impact of its work. The schematic summary below outlines this framework, and indicates that all of HEARD’s activities aim ultimately at mitigating the incidence and impact of HIV and AIDS in southern and eastern Africa. The schematic indicates pathways of knowledge development internal to HEARD, as well as those of learning and of change among various actors who together shape the impact and spread of HIV and AIDS in the region. Our operations and support work provide the foundation for our programme work, and the knowledge and evidence from programme work in turn interfaces with its external environment through its utilisation activities – including those of its communications and marketing division. The real challenges of M&E lie in areas of the framework ‘above the line’, the activities and measurables indicated above the dotted line of the schematic, which are far harder to track than those on or below the line, not only because they are external to the organisation, but also because their trajectory is over varying time and geographic scales. Moreover, the monitoring of external change requires dedicated staff capacity, which is a significant challenge in a climate of diminishing HIV and AIDS funding. Certainly our ‘below the line’ activities went well during 2011. The Standard42
  46. 46. 43 Young Carers team members conducting surveys on the rural field site Operating Procedures (SOPs) developed accessing health care in southern Africa. Under HEARD’s Research Programme, for better research management during HEARD’s African Leadership Programme saw the Young Carers KZN project has been a 2010 have stood the monitoring of utilisation the need to build research knowledge in this partnership between HEARD, the University in good stead. These SOPs together with area, and the Forced Sterilisation Project was of Oxford, Brown University, the South African staff training on ‘getting research into policy conceptualised and subsequently integrated national government and the National Action and practice’ early in 2011 have heightened into HEARD’s Research Programme activities; Committee for Children Affected by AIDS research staff awareness and ability to better a project thus ‘backing’, as it were, from (NACCA). This study is part of a larger national plan for utilisation activities throughout the advocacy work into research work. project, Young Carers SA, that aims to inform development and implementation of research policy and programming in order to improve projects, and beyond. The project saw a collaboration between the wellbeing of children and families. The research and advocacy organisations which Young Carers SA study provides a cutting edge A cornerstone of effective ‘below the provided a healthy tension between the example of research planned for maximum line’ research utilisation, is inter-programme practical demands of evidence for advocacy impact and uptake among decision makers. collaboration. HEARD’s research and on one side, and the rigours of sound scientific It is the world’s first large scale quantitative advocacy work on forced sterilisation, which research work on the other. This led to a study of the impacts of familial HIV and AIDS investigated the experiences of sterilisation project that engaged multiple stakeholders on children, and has been developed and of HIV positive women in Gauteng and at the outset of the work, such as women’s conducted in close collaboration with South KwaZulu-Natal, is a good example of a project rights groups and the Department of Health. African national government departments that is a product of this collaboration. The Coupled with evidence that is defendable, and NGOs. To date over 30 presentations documentation of cases of coerced and forced these stakeholder linkages offer avenues have been made to all social cluster South sterilisations in Namibia, starting in 2007, for both advocacy and research uptake, and African government departments, the SADC fuelled growing international concern over can pave the way for identifying additional region governments, and major NGOs such the threat to the rights of HIV positive women research needs. as UNICEF, USAID, Save the Children and2011 RESEARCH UTILISATION
  47. 47. the WHO. A presentation made at the South Under HEARD’s Gender Equality and HIV African AIDS Conference in June 2011 was Prevention Programme, research utilisation awarded the ‘Best Paper’ for findings on TB has flourished in an environment tightly co-infection between AIDS affected caregivers focussed on addressing gender equalities and their HIV positive children. in the region through synchronised work on research, research utilisation and policy The project has also received good press reform. coverage, with at least 17 newspaper and internet media articles and podcasts totalling Under the ALP, HEARD’s work on 12 050 viewings. Two participant-led movies disability has also very successfully integrated are underway, and the Teen Advisory Group research, research utilisation and advocacy ‘Young Carers’ film will be used as part orientated work – including policy reform. of a Save the Children guide for NGOs in During 2011, HEARD’s Disability and HIV programming for work with vulnerable children. Project focused on dissemination of previous A short documentary film and other multimedia research results, knowledge translation pieces with caregiver participants from the and development of new applied research KZN rural field site are currently being finalised projects. One of many achievements this and are soon to be released. The documentary year has been the translation of HEARD’s film production represents a participant- research on the National Strategic Plans led process and provides an account of (NSPs) into an international disability-inclusive caregivers’ experiences of supporting children NSP framework under an international task in an impoverished community affected by team chaired by HEARD, and launched HIV. The documentary and other multimedia and disseminated in a special session on tools will be used for community dissemination the ‘Intersectionality of disability and HIV’ at as well as dissemination to broader audiences. ICASA 2011 in Addis Ababa, Ethiopia. This work also led to a special session focused on In all, the careful planning, tightly managed HIV related disability at the first International research and energy put into utilisation and HIV, Social Science and Human Science advocacy on the project has led to several Conference in Durban, South Africa during key national and international policies directly June. HEARD’s Disability and HIV Project utilising the Young Carers research findings, continues to feed into the disability network including ‘SADC Minimum Package of via quarterly newsletters and updates on the Services for Orphans and Vulnerable Children disability section on HEARD’s website which and Youth’, the ‘South African National Action receives more than 3 000 hits a month. Plan for Children Infected and Affected by HIV/ Community activists pictured at AIDS’, and the ‘World Health Organization the ICASA Conference Ethical Guidance notes for working with adolescents’.44
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