Reviewing Development and Humanitarian Programmes

We review our development and humanitarian programmes to assess their relevance to reducing vulnerability to HIV infection and addressing the consequences of HIV.

The nature of development and humanitarian work means that all the people with whom we work are likely to be vulnerable to HIV and its consequences to some extent. However, a sharper focus on how HIV and AIDS have changed the context for development and humanitarian work is needed, to enable the expertise of development and humanitarian NGOs to be bought to bear in responding to the causes and consequences of HIV.

Development and humanitarian NGOs need to explore and understand the way HIV and AIDS affect people's daily lives: in income-generating activities such as agriculture, trading or holding a job; in household activities such as raising children, attending school, caring for family members who are ill, and managing one's own illness; and in how people engage in their communities. The increased burden of illness and caring for those who are sick most often falls on women and girls and older family members, such as grandparents. In turn, this affects people's capacity to participate in the community, rendering them invisible and reducing their access to development and humanitarian programmes. Poverty escalates as the result of illness or death of an income-generating family member. Changes in household composition, such as child-headed, female-headed or grandparent-headed households, may mean that programmes need to be targeted differently or ways of working need to be adjusted in order to reach those who need them and address their particular needs.

Humanitarian NGOs need to understand the nature of vulnerability to HIV infection and the implications of HIV in emergency settings. Emergencies involve an array of factors that affect vulnerability to HIV infection and compound the affects of HIV:

  • poverty and social instability affect the cohesion of families and communities, often weakening social norms that regulate behaviour
  • women and children are at increased risk of violence, and can be forced into having sex to gain access to basic needs such as food, water and sanitation
  • displacement can bring populations, each with different HIV prevalence levels, into contact with one another
  • health infrastructure may be stressed, affecting access to basic care for PLHIV and affected communities, and
  • poor infection control, lack of availability of condoms and the presence of military forces, peacekeepers or other armed groups can contribute to increased transmission rates.

Mainstreaming HIV is a learning process that requires development and humanitarian NGOs to understand:

  • how HIV and AIDS change the context for their programming and affect the nature of their work
  • whether and how programmes may reduce or inadvertently increase vulnerability, and
  • how specific programmes can respond to vulnerability to HIV and its impacts, given the particular expertise of NGOs.

Community research is vital to understanding the way in which HIV and AIDS affect people in a given context. We need to involve PLHIV and affected communities, including families, partners, dependants and carers of PLHIV, in participatory assessment to understand and respond to unmet needs, and in the design, implementation and evaluation of programmes that are adapted to meet identified needs.