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Health challenges

This report documents the findings of Local Voices, a six month qualitative research project that provided HIV orphans, vulnerable children and their carers with the opportunity to discuss and document the difficulties they face providing food, water and healthcare for their families. Through meetings, detailed interviews and discussions, the project initiated and developed an ongoing dialogue with 20 families in four areas of the Kitwe district in the Copperbelt province of Zambia: Chimwemwe, Kwacha, Chipata and Zamtan.

It is argued that the project provides insight into two key areas:

• adding a household perspective to existing ideas and analysis of food security in an HIV/AIDS context
• highlighting the knowledge and learning that can be gained when people living with a positive HIV diagnosis are seen as ‘experts’ and their experiences are used to help identify and address the problems they face

The authors argue that HIV/AIDS is not only a health issue but also a disease that impacts on the social structures of household economies and communities. It is asserted that an integrated approach at both the community programming and policy level is needed: incorporating health, nutrition, food security and education. A number of recommendations are given to this end, including:

Policy level:

• provision of free ART must be partnered with the delivery of economic empowerment through interventions such as agricultural programmes adapted to suit the capacity and needs of HIV affected households
  
• HIV/AIDS initiatives must be developed, monitored and evaluated to mitigate the impact HIV/AIDS has on orphans and the carers

Civil society:

• good quality care of people living with HIV/AIDS must be integrated into the work of water and sanitation, public health and food security sectors. In particular, interventions must be designed to address the social and economic impact HIV/AIDS has on food security, diversification/loss of labour, elderly & child headed households, risky coping strategies, reduced educational opportunities, decline in parental care and increased nutritional needs

Community intervention:

• outreach programmes must include components that strengthen community mechanisms to support HIV orphans and vulnerable children, tackle stigma and provide health and nutrition education using the positive living approach
  
• longer term support to communities must empower and protect community leadership networks to advocate on their own behalf
  
  
  
  
  
  
  
  

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