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Changes in life expectancy in selected African countries with high and low HIV prevalence: 1950 - 2005 65 60 with high HIV prevalence: Zimbabwe 55 South Africa Life expectancy (years) Botswana 50 45 with low HIV prevalence: 40 Madagascar Senegal Mali 35 30 1950–1955- 1960- 1965- 1970- 1975- 1980- 1985- 1990- 1995- 2000- 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision.
what have we learnt? effective responses to HIV/AIDS are people-driven, not commodity driven service provision is required, but is no substitute to people driven responses progress hinges on local partnerships
we are the subjects of the response to HIV/AIDS community family personal people work policy
Local Partnerships to HIV/AIDS – The Key for AIDS Competence People of influence Providers of services Teachers Local Religious Leaders Nurses and doctors LF People living Traditional Leaders with HIV/AIDS Families Women Groups Youth Clubs Civil societyLF: Local Facilitation
country-wide AIDS progress horizontal sharing of AIDS- competence from community to community scaling-up of locally available services and financial resources facilitative, catalytic leadership
Knowledge-sharing LFT LFT Churches UN Business LFT LFT Civil society DFT Government sectors CBOs NGOs Persons living with LFT HIV/AIDS LFTDFT: District Facilitation Team.
Regional Partnerships Religious leaders Governments UN RFT National Partnerships GFT Donors NGOs NFT Foundations Business District Persons living withPartnerships HIV/AIDS Global Partnerships DFT DFT LFT Local LFT LFT Partnerships GFT: Global Facilitation Team
The Constellation for AIDSCompetence Connecting local responses around the world Committed to the goal of AIDS Competence and Committed to HCD as a strategy Founded on December 8, 2004
Our vision and mission We envision a global society in which each element is pursuing AIDS competence. Our mission is to connect people involved in local responses to AIDS around the world for mutual support, learning and transformation. We are made of learning communities whose members support and learn from each other in their own journey towards AIDS competence. We cooperate with any other organisation which pursues a similar vision and approach to the resolution of global development challenges.
What makes us different? We see people primarily as the subjects of the response to AIDS, not as the targets of interventions. We connect people for learning; we do not seek to organise resources. Each of us is linked to local responses and is inspired by the experience. We start from within: ourselves, and the organisations we belong to.
Our Goal: AIDS Competence In an AIDS Competent society, we – as we relate to families, to communities, to our work and to policy– act from strength to: acknowledge the reality of HIV and AIDS, build our capacity to respond, reduce our vulnerability and risk, allow everyone to live out their full potential, and share our experience with others.
Our ApproachHuman Capacity for Response We care We change We learn We belong We transfer
the challenge to the true leader appreciates local strengths and assets seeks to understand rather than to judge stimulates interaction among various partners values listening over talking prefers asking questions over providing answers chooses learning over teaching
organisations: shifting attitudesWe believe in our own We believe in people’sexpertise to provide strengths to respondsolutionsWe control a disease We facilitate responsesWe respond to need We reveal strengthYou have a problem Together, you and we have solutions
facilitation teams: goalsmembers assist each other to: learn from local responses stimulate knowledge creation and sharing embed lessons learnt into organisations participate in knowledge sharing worldwide
Ways of Working participation is voluntary responds to invitations any community can invite no internal hierarchy one organisation serves as host
Self-Assessment of AIDS competence 1 5 2 3 4 BASIC HIGH We acknowledge openly We recognise our own We recognise that with others our concerns strength to deal with theAcknowledgement We know the basic facts We recognise that HIV is a HIV/AIDS is a problem for about HIV/AIDS and the challenges and seek and Recognition about HIV/AIDS. problem. us and we discuss it challenges it represents others for mutual support amongst ourselves for us. and learning. We communicate We adapt and Our care and prevention We intentionally link careCare and change of externally provided communicate externally activities are separate and We change because we and change of behaviours behaviour messages about care and provided messages about dependent on external care. and work practices in prevention. care and prevention. stimulus. ourselves and with others. Our partnerships share We (individuals, families, We get together with common goals, and define communities, service We address and resolve all We don’t involve those some people who are each partner’s Inclusion affected by the problem. crucial to resolve common providers and policy contribution. Religious challenges facing us (not makers) work together to only HIV/AIDS.) issues. and community leaders respond to HIV/AIDS. get involved. We are addressing Identify and We aware of the general We have a clear strategy vulnerability in all aspects We have mapped Our strategy is based on address factors of vulnerability vulnerability and risk. to address vulnerability good practices. of the life of our group, vulnerability and the risks affecting us. and risk. all are aware and involved in responding. We have processes for We learn, share and apply We learn by what we do We see an improvement in We share learning from learning and sharing which what we learn Learning and rather than what we learn local responses as a result our successes but not our we use sometimes. We systematically, and seek transfer from and share with of our learning and mistakes. seek people of experience people with relevant others. sharing. when necessary. experience to help us. We measure our change We invite others to help We measure our own Our change is evaluated We begin consciously to systematically and can measure our change andMeasuring change by others. self measure. progress and set targets demonstrate measurable share learning/results for improvement. improvement. with others.
Self assessment People: talk exchange perspectives get to grasp the local reality define priorities and actions adapted to context follow up formulate lessons learned identify what experience to share and what to experience to seek
Follow up: One Example Cinq Districts in Bangkok
Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok DistrictsLevel 5 Level Acknowledgment and 5 Inclusion 4 recognition 4 3 3 2 2 1 1 0 0 Ladkrabang Klongsan Nonchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae NongkhamLevel Level5 Care and prevention 5 Identify and address4 vulnerability 43 32 21 10 0 Ladkrabang Klongsan Nongchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae Nongkham Pre-intervention Post-intervention Post-intervention year 1 year 2
Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok DistrictsLevel Level Learning and transfer Adapting 5 5 4 4 3 3 2 2 1 1 0 0 Ladkrabang Klongsan Nongchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae NongkhamLevel 5 Level Ways of working 5 Mobilizing resources 4 4 3 3 2 2 1 1 0 0 Ladkrabang Klongsan Nongchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae Nongkham Pre-intervention Post-intervention Post-intervention year 1 year 2
Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok DistrictsLevel Level 5 Access to 5 Measuring treatment change 4 4 3 3 2 2 1 1 0 0 Ladkrabang Klongsan Nongchok Bangkae Nongkham Ladkrabang Klongsan Nongchok Bangkae Nongkham Pre-intervention Post-intervention Post-intervention year 1 year 2
Ac kn ow Level le dg em en t 1 2 3 4 5 C ar e an d C ha ng e In cl us i on Vu ln er a bl e gr ou psLe ar ni n g an d tra ns fe r Mae Chan M ea su rin g ch an ge Ad ap ti n g W ay s of w or Current levels for Mae Chan community ki ngM ob ilis in g re so ur ce s
Ac kn ow Level le dg em en t 1 2 3 4 5 C ar e an d C ha ng e In cl us i on Vu ln er a bl e gr ou psLe ar ni n g an d tra ns fe r Mae Chan M ea su rin g ch an ge Levels for other communities too Ad ap ti n g W ay s of w or ki ngM ob ilis in g re so ur ce s
Ac kn ow Level le dg em en t 1 2 3 4 5 C ar e an d C ha ng e In cl us io n Vu ln er ab le gr ou psLe ar ni ng an d tra ns fe r Mae Chan M ea su rin g ch a ng e Ecart entre les niveaux actuels Ad ap tin g W ay s of w or ki ngM ob ilis in g re so ur ce s
Ac kn ow Level le dg em en t 1 2 3 4 5 C ar e an d C ha ng e In cl us i on Vu ln er a bl e gr ou psLe ar ni n g an d tra ns fe r Mae Chan M ea su rin g ch an ge Ad ap ti n g Le niveau de Mae Chan – “la rivière” W ay s of w or ki ngM ob ilis in g re so ur ce s
Ac kn o Level w le dg em en t 1 2 3 4 5 C ar e an d C ha ng e In cl u si on Vu ln er ab le gr ou psLe ar ni ng an d tra ns fe r Mae Chan M ea su rin g ch an ge Ad ap ti n g W ay s of w or ki ngM ob ilis in g re so ur ce s
Something to learn, something to shareCurrent level Something Acknowledgement to share 5 Mbarara & Recognition 4 Match making to put those with something to learn in touch with Pallisa 3 Busia Kibaale 2 Rakai Arua Something to learn those with something to share via a Peer 1 Moroto Assist meeting or an Progress electronic forum. 0 +1 +2 +3 +4 Improvement Objective
Knowledge Assets What are the top ten things I need to know? Where can I get more detail? What can I re-use? Who can I talk to? A few Even more Still more More More More Lessons Lessons Lessons Learned
Peer Assists – Learning before doing Action What you know "...the politics What’s in your context accompanying possible? hierarchies hampers the free exchange of knowledge. People are much more open with What we What I know their peers. They are both know in my context much more willing to share and to listen.” Lord John Browne
Context and detail – where andwhen you need it… • • “ • • “ “ • • “ “ “
A Knowledge AssetPrinciples (or advice) Experience which leads to the principle Resources (Documents, Policies, People)Believe that Capacity for care, change, leadership and hope HCD Concept Paper people/commun as transferable concepts which have Action Research ities have been seen and documented in multiple (SA) capacity, countries experience and knowledge to shareWork as a team: co- Team leadership development is done through AFCN process facilitating and attaching people to teams with more Hope World- mentoring new experienced facilitators, allowing people wide/Enda team members to practise with support of a team, and Sante/SA in every process then handing over team leadership to partnership others….
Two ideas• The Constellation for AIDS Competence• Friends for Life
Managing Knowledge? “The idea is not to create an encyclopaedia of everything that everybody knows, but to keep track of people who ‘know the recipe’, and nurture the technology and culture that will get them talking” Arian Ward, Hughes Space & Communications Capturing Connecting
The “Stairs” Diagram Performance Manage Corrosion Cooper5 River High performance Bulwer4 Island Feluy High desire to improve Lavera Grangemouth3 Chemicals Texas City Geel Coryton Joliet Kwinana2 Feluy Decatur FPS Netherlands Trinidad Oil1 Hull Gap between 0 1 2 3 4 current and target