HIV in rural areas. FAO documents

[Guest guest]

The Implications of HIV/AIDS for Rural Development Policy and

Programming: Focus on Sub-Saharan Africa: by Daphne Topouzis

Consultant. Sustainable Development Department, FAO

HIV and Development Programme, UNDP

June 1998 This page presents the Table of contents and Executive

summary of the paper. The full paper is also available for downloading

via FTP (MS-Word 6, zipped, 74K)

Table of contents

Executive summary

Acknowledgements

Glossary of terms and acronyms

1. Introduction: Purpose and scope

2. The interface between the rural institutional environment and HIV

2.1 The rural dimension of HIV

2.2 Rural susceptibility and vulnerability to HIV/AIDS

2.3 Why do rural institutions need to address HIV/AIDS?

2.3.1 The inter-relationships between formal rural institutions and HIV

2.3.2 The inter-relationships between informal rural institutions and HIV

2.4 Aligning rural development policies and programmes with the

response to HIV

3. Conceptual framework on the implications of HIV/AIDS for rural

development policies and programmes

3.1 Key cross-cutting issues

3.2 Rural development policy and programme focus areas

3.2.1 Poverty alleviation

3.2.2 Food security and sustainable livelihoods

3.2.3 Empowerment of rural women

3.2.4 Labour

3.2.5 Infrastructure

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

4.1 Rural institutional strengthening/capacity building

4.1.1 Rural development sector/sub-sector

susceptibility/vulnerability assessment

4.1.2 Human resource needs/capacity assessment of rural institutions

4.1.3 Participatory training for rural institutions and their clients

4.1.4 Policy and programme review

4.1.5 Mandate on HIV/AIDS

4.1.6 Management Information System on HIV/AIDS in rural areas

5. Conclusions

6. Bibliography

Executive summary

This paper examines the implications of the HIV epidemic for rural

development policies and programmes in sub-Saharan Africa and, in

particular: the inter-relationships between rural development and

HIV/AIDS; and the broad policy and programming challenges that the

epidemic poses for rural institutions. The proposed conceptual

framework for the identification of key policy and programming issues

for rural development raised by HIV is intended to provide guidance

for the design and conduct of a set of four case studies to be carried

out in Southern and Eastern Africa. The main objective of the case

studies will be to help formal and informal rural institutions

generate policy and programme responses to the HIV epidemic (in the

areas of land tenure, agricultural research, training and extension,

appropriate technology, credit, etc.) in each of the four countries.

The relationships between rural institutions and HIV/AIDS are

bi-directional:

1. the epidemic may have an effect on rural institutions. The

effects of HIV/AIDS on formal rural institutions may: i) impoverish

directly affected clients; ii) erode the capacity of rural

institutions through losses in human resources; and iii) disrupt the

smooth operation of rural institutions by severing key linkages in the

organisational and/or production chain. The effects of HIV/AIDS on

informal rural institutions may create a crisis of unprecedented

proportions particularly among the extended family and kinship

systems, with implications not only for the spread of HIV but also for

the viability of rural institutions and of traditional social safety

mechanisms (widow inheritance, child fosterage, etc).

2. the policies and programmes of rural institutions may have a

positive or negative effect on the HIV epidemic (i.e. by enhancing

mobility and strengthening urban-rural linkages, they may

inadvertently facilitate HIV transmission; by improving support and

social services, they may contain the spread and impact of the epidemic).

The following key points cross-cut the proposed conceptual framework

on the implications of HIV/AIDS for rural development policy and

programming:

1. The causes and consequences of the HIV epidemic are closely

associated with wider challenges to development, such as poverty, food

and livelihood insecurity, gender inequality. In effect, HIV/AIDS

tends to exacerbate existing development problems through its

catalytic effects and systemic impact.

2. In areas heavily affected by HIV/AIDS, the catalytic effects and

systemic impact of the epidemic on rural development may:

* amplify existing development problems to such an extent as

to trigger structural changes (i.e. in adult and infant mortality); and/or

* create new problems and challenges for rural development

(child-headed households, the breakdown of informal rural institutions

and thus of certain vital social safety net mechanisms).

3. Given that many problems arising from the epidemic are not

specific to HIV/AIDS, policy and programme responses need not be

HIV/AIDS-specific but must address the root causes and consequences of

the wider challenges to rural development. In other words, a

developmental rather than an AIDS-specific focus is critical to

tackling the multi-sectoral complexity of the epidemic and its

systemic impact and to ensuring the sustainability of both HIV/AIDS

responses and rural development efforts.

4. The policy environment plays a key role in defining the

parameters of susceptibility/vulnerability to HIV/AIDS and of the

impact of the epidemic.

5. Gender, age and marital/family status play as decisive a role in

determining susceptibility/vulnerability to HIV/AIDS and the potential

impact of the epidemic as economic and cultural conditions. For this

reason, the interplay between these factors needs to be considered at

each stage of policy and programme development.

6. The policy and strategy recommendations put forth by the World

Conference on Agrarian Reform and Rural Development and by the World

Food Summit in particular provide a springboard from which to

mainstream HIV/AIDS in rural development policies and programmes. In

particular, WCARRD's focus on poverty alleviation and participation by

rural people in the institutions that govern their lives as a basic

human right, and the World Food Summit emphasis on food security and

sustainable human development are not only prerequisites for the

revitalisation of the rural economy, but also for effective responses

to HIV/AIDS.

7. Rural development policies and programmes in support of poverty

alleviation, food and livelihood security, the empowerment of rural

women, etc. are, in effect, also HIV prevention and AIDS mitigation

measures and vice versa.

8. While rural development programmes can be integrated with

HIV/AIDS prevention and mitigation programmes, HIV/AIDS-specific

policies and programmes have an important complementary role to play.

The proposed conceptual framework focuses on selected rural

development focus areas, and in particular on:

Poverty alleviation

This section examines the broad inter-relationships between poverty

and HIV, identifying gaps in knowledge (i.e. on household coping

strategies), critical issues that are not currently being addressed

(such as the consequences of HIV-related inter-generational poverty

and of the increasing asset/land concentration and marginalisation of

the poor) and alternative targeting criteria (such as adult death

and/or household dependency ratios) for poverty alleviation programmes.

Food security and sustainable livelihoods

The dynamics of labour mobility/ migration and food

security/sustainable livelihoods are critical dimensions of HIV

transmission and impact. This section raises the issue of the

sustainability of labour-intensive food production strategies, upon

which food security policies and programmes are often based, given

labour shortages arising from HIV/AIDS, drought, migration and other

factors. The issues of labour shortage and livelihood insecurity and

of food/livelihood security coping mechanisms of informal rural

institutions to HIV/AIDS impact are also examined.

Empowerment of rural women

Gender inequality facilitates the spread of HIV and exacerbates its

impact. This section examines: a) the gender-specific impact of young

adult mortality; the gender (and age/marital status) differentiated

effects of HIV on household income and expenditures; and c) the

interface between formal and informal rural institutions, gender and

HIV/AIDS as manifested in traditional social safety net mechanisms for

women, such as widow inheritance, and the implications of the adverse

effects of such practices for women.

Labour

The heterogeneity of labour is highlighted as a critical factor in the

analysis of the impact of the epidemic. Human rights, production and

productivity issues, employment and labour market issues resulting

from the impact of HIV/AIDS are examined in terms of their policy and

programme development implications. More specifically: the role of the

workplace in HIV prevention; lost skills and experience; the

substitutability of labour; losses in production and rising payroll

costs are analysed in the context of HIV/AIDS.

Infrastructure

The implications of construction, maintenance and operation of rural

infrastructure are examined in terms of their potential positive or

negative contribution to the spread and impact of the epidemic. The

impact of HIV/AIDS on rural housing, and thus on rural living

conditions, is also examined.

Participatory, gender-sensitive and multi-sectoral rural development

policies and programmes are essential elements of any response to

HIV/AIDS. The need to develop capacity-building strategies to improve

the planning capabilities of agricultural and rural development

institutions and to help them cope with the loss in human resources

and other effects of the epidemic is underscored. Rural institutional

strengthening and capacity-building activities that will also assist

the case studies to generate policy and programme responses may

include one or several of the following components of the menu of

options proposed below:

1. Rural development sector/sub-sector susceptibility/vulnerability

assessment (why and how is a sector/sub-sector vulnerable to HIV/AIDS?

which population/employee groups are most susceptible/ vulnerable? How

do labour conditions facilitate HIV transmission? etc.)

2. Human resource needs/capacity assessment of public and private

rural development institutions, to evaluate the degree to which their

policies and programmes are aligned with the effects of the epidemic

and with the implications of human resource losses.

3. Participatory training for rural institutions and their

clients/target groups in: bottom-up, cross-sectoral, gender-sensitive

planning; the implications of HIV/AIDS for rural development; 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 set policies.

4. Policy/programme review (national and district level rural

development policies and plans, etc) to take into account the dynamics

and impact of the epidemic; to enhance multi-sectoral collaboration

among rural development programmes; and to integrate rural development

programmes with HIV/AIDS prevention and mitigation programmes.

5. Creating a mandate on HIV/AIDS and generating political

commitment at the highest level for HIV/AIDS. Setting up a Management

Information System on HIV/AIDS in rural areas.

* Download full document Implications of HIV/AIDS for rural

development policy and programming: Focus on Sub-Saharan Africa

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