Study Paper No. 6
THE IMPLICATIONS OF HIV/AIDS FOR RURAL DEVELOPMENT POLICY AND PROGRAMMING:1 Focus on Sub-Saharan Africa

4. Rural development policy and programme planning for HIV/AIDS


Policy and programme planning considerations that need to be highlighted include the following:

  • Demand-driven, participative, and gender-responsive rural development policies and programmes are a prerequisite for effective response to HIV/AIDS. Without bottom-up, inclusive and gender-sensitive policies and programmes, it is unlikely that HIV/AIDS will be successfully and sustainably integrated in rural development. This entails political commitment at each stage of the programme cycle or activity and cross-sectoral collaboration.
  • There is a need for a shift in analysis from the impact of the HIV epidemic to the interface between formal and informal institutions and HIV/AIDS. The case studies should focus on this interface when generating policy and programme responses to HIV/AIDS.
  • The implications of the inter-generational effects of HIV on rural development, that is, the present and future implications of the growing problem of children for rural development (given their poor education and health, potential low labour productivity and lack of applied agricultural skills and experience). In particular, it is important to determine how this issue can be incorporated in policy and programme planning.

The need for political commitment for action at all levels cannot be underscored enough. Without the committed support of formal and informal political institutions, neither the resources nor the recognition of why and how the epidemic needs to be addressed across sectors will be forthcoming. The question is how can political commitment be ensured when even high HIV prevalence countries tend to overlook HIV (excluding health sectors)? Endorsement at the highest political level is certainly a first step (as was the case in Uganda). Finding ways of establishing and operationalising inter-sectoral programmes needed for decentralised responses to development problems (poverty, gender inequality, inequity, etc.), including the HIV epidemic, is another key step that needs to be addressed in the case studies.


4.1 Rural institutional strengthening/Capacity-building

National planning capacity with regard to the impact and consequences of HIV on rural development can be enhanced by:

  • improving the capacity of rural institutions to assess the current and future impact (to the extent needed for planning purposes);enhancing information-sharing about assessments done in other countries;
  • improving the capacity of rural institutions to undertake participatory, bottom-up, gender-responsive planning;98
  • assessing the susceptibility and vulnerability to HIV/AIDS of the staff and clients of rural institutions;99
  • conducting a needs and capacity assessment of key rural development institutions (formal and informal); and
  • improving coordinated impact planning involving multiple sectors.

To this effect, there is also a need to enhance linkages between formal and informal rural institutions by improving:

  • information flow up, down and across the planning ladder;
  • communication, dialogue and negotiation at all levels - grassroots, intermediate and policy;
  • linkages and partnerships between all levels of stakeholders, and
  • the participation of rural men and women in planning processes at all levels.

The activities proposed below are intended to serve as a menu of options for the case studies and can be used according to need and circumstances. The selection and utilisation of each activity will depend on the magnitude and impact of the epidemic, the existing policy environment on HIV/AIDS and infrastructural facilities, and the extent to which these issues have already been addressed to date.

4.1.1 Rural development sector/sub-sector susceptibility/vulnerability assessment

The first task in planning for HIV/AIDS is to assess the vulnerability of rural development as a sector (why and how is a rural development sector vulnerable?). Next, an assessment of the susceptibility and vulnerability of selected rural development sub-sectors can be undertaken, with a view to identifying the potential consequences of the epidemic and more specifically, which population/employee groups and work environments carry the most risk of facilitating HIV transmission. These assessments should be conducted interactively to ensure that there is a two-way exchange of information between researchers and rural institutional staff and that the findings reflect the views and felt needs of local people.

4.1.2 Human resource needs/capacity assessment of rural institutions

A needs and capacity assessment of selected formal and informal rural development institutions will allow policy-makers and planners to identify gaps in capacity as well as potential areas of support, including:

  • training needs (who needs to be trained in what?);
  • HIV/AIDS-related activities that can be undertaken given existing organisational and logistical constraints;
  • areas where rural institutions may need financial, technical or other assistance;
  • research and extension priorities; and
  • key areas of multi-sectoral collaboration and modalities of operationalising cross-sectoral policies and programmes.

The findings can be used to design targeted HIV/AIDS IEC programmes, which can then be delivered by:

  • government or NGO extension workers, community development workers or health workers;
  • informal rural institution leaders or trained volunteers; and
  • private sector health or personnel staff.


4.1.3 Participatory training for rural institutions and their clients

Once needs have been identified, gaps in institutional capacity can be dealt with through workshops or informal seminars aimed at raising awareness on the bi-directional relationships between HIV/AIDS and rural development (medical as well as technical aspects) among selected formal and informal rural institution staff (professional and support staff) and their clients/target groups.

Training may focus on: bottom up-cross-sectoral, gender-responsive planning; the implications of HIV/AIDS for particular rural development sub-sectors; and mechanisms that move field-based information on the bi-directional relationships between HIV and rural development up the planning ladder so as to influence how planners and policy-makers think, how they plan responses and how they set policies. This exercise will enhance capacity-building and help integrate HIV in the work of rural development institutions.


4.1.4 Policy and programme review

The following activities can be undertaken in a policy and programme review of formal rural institutions:

  • Review jointly with rural institution staff existing policies and programmes (including policy documents, plans of action, programme documents, etc.) in terms of planning process mechanisms, targetting techniques and methodologies used) and assess whether they:
  1. are participatory, gender-responsive and multi-sectoral;
  2. target those most vulnerable to poverty, drought, and HIV/AIDS (female-headed households, pastoralists, artisanal fisherfolk, displaced populations, etc.) and address their needs as perceived by the target groups themselves;
  3. include the target groups (men and women) in the entire planning process and in development activities;
  4. are aligned with the effects of HIV/AIDS, and more specifically, whether they:

    --take into account the gender, equity and population dimensions of development in existing policies and programmes;
    --consider the potential impact of accelerated economic development on the lifestyles of different rural population/employment groups in terms of whether they may facilitate HIV transmission; and
    --address the needs of households affected by HIV/AIDS.


4.1.5 Mandate on HIV/AIDS

Formal rural institutions need to elaborate mandates on HIV/AIDS as a first step toward legitimising efforts to address the epidemic on a systematic basis. Without a mandate on HIV/AIDS, it is unlikely that the staff of rural institutions will feel authorised or compelled to address issues related to the epidemic and take the necessary action. Institutional policies on HIV/AIDS will also facilitate the operationalisation of a multi-sectoral response to the epidemic. For this reason, key government departments, NGOs, CBOs and the private sector need to be involved in the conceptualisation, drafting and endorsement of the mandate. To ensure political commitment, the mandate needs to be endorsed at the highest political level.

4.1.6 Management Information System on HIV/AIDS in rural areas

A basic Management Information System (MIS) needs to be set up in rural areas to: a) provide information on HIV/AIDS for local populations; and b) generate information and HIV sentinel surveillance data for rural areas, evaluate the magnitude of the epidemic, and monitor on-going activities and their costs. The complexity of the MIS should be determined on the basis of planning purpose needs. Although the MIS will be primarily the responsibility of the health sector, the rural development sector can also play a role in the design of the MIS and contribute to it. Data from the surveillance system can then be distributed and disseminated to relevant rural institutions. Informal meetings can be held with representatives from formal and informal rural institutions and their beneficiaries to analyse the findings jointly and to deliberate on their implications for rural development policies and programmes.

Notes:

98. FAO, UNDP and the World Bank have developed a Socio-Economic and Gender Analysis (SEAGA) training programme to help countries formulate gender-responsive, pro-poor and environmentally sustainable programmes. FAO has developed for SEAGA a common theoretical perspective that integrates inter-household and intra-household socio-economic and gender analysis and is intended to provide essential inputs for programme and policy formulation in the areas of poverty alleviation, equity, empowerment and environmental sustainability. Technical supplements covering dairy development, fish processing, farm mechanisation, irrigation, plant genetic resources, and biodiversity and indigenous knowledge are also available. These could be adapted by FAO, upon request, and used by rural development institutions.

99. FAO's Agricultural Education, Training and Extension Service has developed a generic prototype KAP Survey Questionnaire on HIV/AIDS and its implications for agricultural extension (AIDSIMAX). See "Developing a Generic Prototype KAP Survey Questionnaire on HIV/AIDS and its Implications for Agricultural Extension," based on workshop proceedings in Penang, Malaysia, December 1995. See also Fighting AIDS in Rural Areas: Why and How Should Extension Workers Help, FAO, 1996.