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A case study of HIV/AIDS prevention in Nigeria : assessment and recommendations

This is a two-stage study of HIV/AIDS prevention. In Stage One, the study examines the HIV/AIDS approach of Western aid organisations (INGOs) and compares it to the lived realities of people who are most 'at risk', sex workers, unemployed street youth, and married low income families, in the poor migrant community of Ajegunle in Nigeria�s Lagos state. The study found that INGOs and their client NGOs emphasised Western medical models of HIV/AIDS for both intervention (e.g. testing and ARV drugs for management) and prevention (e.g. through education and behaviour change).
In contrast, among 'at-risk' groups, the study revealed a high degree of knowledge about the transmission of HIV/AIDS (contrary to Western medical assumptions), but also detected strong feelings of powerlessness in being able to address it. INGOs and their client organisations were operating at the levels of tertiary or curative and secondary or behaviour change prevention, whereas the views of the local 'at-risk people' indicated relevance of the primary prevention level, the social structural conditions of the people.
In analysing the results of the first stage of the study, the findings identified a process of 'talking past each other' by official aid agencies and those most at risk, thereby inhibiting effective prevention. The INGOs and NGOs used their financial power, based on the gross inequality in the world distribution of resources, to dictate their own agendas, omitting primary intervention and instead concentrating on secondary and tertiary prevention. The study suggests that new thinking about multi-sectoral responses with full community participation is necessary in order to engage in more effective preventive action.
The study then sought out alternative sources of power that might permit that to happen, notably the strengths of the local Ajegunle community. As a poor community, they lacked financial resources and human capital, such as skilled workers, but they had significant knowledge capital about their own circumstances and the realities people faced. The community also had considerable cultural capital and local organisations with considerable relational capital around community links, broad based support and commitment to such action.
This analysis suggests the need to identify and work through the power differentials using community development processes, especially seeking to empower local communities to take part in decision-making over prevention, if effective action is to take place. The process required is one of a negotiated, inclusive partnerships for sharing information, experience, and decision-making, involving all the relevant stakeholders - the International Organisations (INGOs), National NGOs, Community Groups and the community itself.

Identiferoai:union.ndltd.org:ADTP/217816
Date January 2008
CreatorsIyiani, Christian, n/a
PublisherUniversity of Otago. Department of Social Work and Community Development
Source SetsAustraliasian Digital Theses Program
LanguageEnglish
Detected LanguageEnglish
Rightshttp://policy01.otago.ac.nz/policies/FMPro?-db=policies.fm&-format=viewpolicy.html&-lay=viewpolicy&-sortfield=Title&Type=Academic&-recid=33025&-find), Copyright Christian Iyiani

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