Our Journey towards AIDS Competence

Changes in life expectancy in selected African countries with high and low HIV prevalence: with high HIV prevalence: Zimbabwe South Africa Botswana with low HIV prevalence: Madagascar Senegal Mali Source: UN Department of Economic and Social Affairs (2001) World Population Prospects, the 2000 Revision Life expectancy (years) 1950–

There is another way! Photo: Georgia Roessler

Phayao, Thailand HIV seroprevalence among 21 year old men HIV Seroprevalence, %

Uganda: trends in antenatal HIV prevalence at selected sentinel sites

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

people work work policy policy community personal family we are the subjects of the response to HIV/AIDS

Local Partnerships to HIV/AIDS – The Key for AIDS Competence LF: Local Facilitation Civil society LF Youth Clubs Traditional Leaders Women Groups Local Religious Leaders Teachers Nurses and doctors People living with HIV/AIDS Families Providers of servicesPeople of influence

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

LFT Knowledge-sharing LFT UN CBOs Churches Business Government sectors NGOs Persons living with HIV/AIDS Civil society DFT DFT: District Facilitation Team.

Regional Partnerships National Partnerships Local Partnerships NFT Global Partnerships DFT GFT LFT DFT RFT District Partnerships GFT: Global Facilitation Team NGOs Foundations Business Religious leaders Persons living with HIV/AIDS Governments UN Donors

The Constellation for AIDS Competence  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 Approach Human Capacity for Response  We care  We change  We learn  We belong  We transfer

Our Offer  Facilitation capacity  Self-assessment  Knowledge exchange  Knowledge assets  Electronic platforms

Our Offer  Facilitation capacity  Self-assessment  Knowledge exchange  Knowledge assets  Electronic platforms

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 attitudes We believe in our own expertise to provide solutions We believe in people’s strengths to respond We control a diseaseWe facilitate responses We respond to needWe reveal strength You have a problemTogether, you and we have solutions

facilitation teams: goals members 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

Our Offer  Facilitation capacity  Self-assessment  Knowledge exchange  Knowledge assets  Electronic platforms

Self-Assessment of AIDS competence 1 BASIC HIGH Acknowledgement and Recognition We know the basic facts about HIV/AIDS. We recognise that HIV is a problem. We recognise that HIV/AIDS is a problem for us and we discuss it amongst ourselves We acknowledge openly with others our concerns about HIV/AIDS and the challenges it represents for us. We recognise our own strength to deal with the challenges and seek others for mutual support and learning. Care and change of behaviour We communicate externally provided messages about care and prevention. We adapt and communicate externally provided messages about care and prevention. Our care and prevention activities are separate and dependent on external stimulus. We change because we care. We intentionally link care and change of behaviours and work practices in ourselves and with others. Inclusion We don’t involve those affected by the problem. We get together with some people who are crucial to resolve common issues. We (individuals, families, communities, service providers and policy makers) work together to respond to HIV/AIDS. Our partnerships share common goals, and define each partner’s contribution. Religious and community leaders get involved. We address and resolve all challenges facing us (not only HIV/AIDS.) Identify and address vulnerability We aware of the general factors of vulnerability and the risks affecting us. We have mapped vulnerability and risk. We have a clear strategy to address vulnerability and risk. Our strategy is based on good practices. We are addressing vulnerability in all aspects of the life of our group, all are aware and involved in responding. Learning and transfer We learn by what we do rather than what we learn from and share with others. We share learning from our successes but not our mistakes. We have processes for learning and sharing which we use sometimes. We seek people of experience when necessary. We learn, share and apply what we learn systematically, and seek people with relevant experience to help us. We see an improvement in local responses as a result of our learning and sharing. Measuring change Our change is evaluated by others. We begin consciously to self measure. We measure our own progress and set targets for improvement. We measure our change systematically and can demonstrate measurable improvement. We invite others to help measure our change and share learning/results 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

Level Acknowledgment and recognition Inclusion Care and prevention Identify and address vulnerability Pre-intervention Pre-intervention Post-intervention year 1 Post-intervention year 1 Post-intervention year 2 Post-intervention year 2 Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok Districts Level

Learning and transfer Adapting Ways of working Mobilizing resources Level Pre-intervention Pre-intervention Post-intervention year 1 Post-intervention year 2 Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok Districts

Access to treatment Measuring change Level Pre-intervention Pre-intervention Post-intervention year 1 Post-intervention year 2 Post-intervention year 2 Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok Districts Comparison of AIDS Competence Indicators Pre- and Post-Community Self Assessment in 5 Bangkok Districts

Our Offer  Facilitation capacity  Self-assessment  Knowledge exchange  Knowledge assets  Electronic platforms

Mae Chan Acknowledgement Care and Change Inclusion Vulnerable groups Learning and transfer Measuring change Adapting Ways of working Mobilising resources Level Current levels for Mae Chan community

Mae Chan Acknowledgement Care and Change Inclusion Vulnerable groups Learning and transfer Measuring change Adapting Ways of working Mobilising resources Level Levels for other communities too

Mae Chan Acknowledgement Care and Change Inclusion Vulnerable groups Learning and transfer Measuring change Adapting Ways of working Mobilising resources Level Ecart entre les niveaux actuels

Mae Chan Acknowledgement Care and Change Inclusion Vulnerable groups Learning and transfer Measuring change Adapting Ways of working Mobilising resources Level Le niveau de Mae Chan – “la rivière”

Something to learn, something to share Match making to put those with something to learn in touch with those with something to share via a Peer Assist meeting or an electronic forum. Something to share Something to learn Progress Acknowledgement & Recognition 5 Mbarara 4 3 Pallisa Busia Kibaale 2 Rakai Arua 1 Moroto Improvement Objective Current level

Our Offer  Facilitation capacity  Self-assessment  Knowledge exchange  Knowledge assets  Electronic platforms

A few more 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? 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? Even more Still More More Lessons Lessons Learned Lessons Learned Knowledge Assets

What you know in your context What I know in my context "...the politics accompanying hierarchies hampers the free exchange of knowledge. People are much more open with their peers. They are much more willing to share and to listen.” Lord John Browne Peer Assists – Learning before doing Action What we both know What’s possible?

Context and detail – where and when you need it… “ “ “ “ “ “

A Knowledge Asset Principles (or advice)Experience which leads to the principleResources (Documents, Policies, People) Believe that people/commun ities have capacity, experience and knowledge to share Capacity for care, change, leadership and hope as transferable concepts which have been seen and documented in multiple countries HCD Concept Paper Action Research (SA) Work as a team: co- facilitating and mentoring new team members in every process Team leadership development is done through attaching people to teams with more experienced facilitators, allowing people to practise with support of a team, and then handing over team leadership to others …. AFCN process Hope World- wide/Enda Sante/SA partnership

Our Offer  Facilitation capacity  Self-assessment  Knowledge exchange  Knowledge assets  Electronic platforms

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 Cooper River Bulwer Island Lavera Chemicals Feluy Texas City Kwinana Coryton Feluy Joliet Grangemouth Geel Netherlands Decatur Hull FPSTrinidad Oil High desire to improve High performance Gap between current and target Performance Manage Corrosion

Example Stairs diagram