Re: CBO policy of NACO is not right

[Guest guest]

Dear Shaligram,

Re: /message/10606

You are raising many issues and confusing some of them. 

I disagree with you that HIV and AIDS programmes managed by CBO's be it of

PLHIV, Sex Worker, Transgender or MSM do add an immense value to mitigating the

impact of HIV and help lower down prevalence and in many cases incidence of HIV

too.

The second issue that you raise is that of corruption in NGO and CBO's.  I agree

with you that development sector is not untouched from corruption and nepotism. 

I have raised this issue at several forums.

Rather than looking at NACO to help us weed out corruption, which i am sure they

do as and when it comes to their notice, it is up to the sector as well to

regulate itself.  We must find mechanisms for accountability of the development

sector as a whole and that includes INGOs, NGO, and CBOs as well.

Let us put forth suggestions on transparency and accountability in the

development sector.  One of my suggestion is that the INGOs, NGO and CBO/s must

publish a list of the grants that they receive, its purpose and objectives and

expected outcomes either on their websites or any such forms of communication

where the beneficiaries become aware.

Hope this helps to kick start a critical debate that is long overdue.

Warm Regards,

Rajiv

e-mail: Dua <rajivdua@...>

[Guest guest]

Dear Saligramji

The issue you raised have some valid points but it did not reflect any

constructive issue of faliure of CBO policy.

As I uderstand from your mail " This is an issue of curruption not a policy

faliure " . We all accept that curruption is available in all sector so the CBOs

also have.

Mismanagement of funds and diversion from the main issues also happend in NGO

sectors, it dosent mean all the NGOs are currupt same with the CBO. It might be

possible that some of the CBOs are misusing the HIV/AIDS grant

It dose not gave any evidence of policy faliure of CBOs.

Regards

Yogesh

Freelance Consultant

HIV & Public Health

New Delhi

[Guest guest]

Dear Shaligram,

Re: /message/10606

This is to request you to go deep into the issue of CBOs and the contributions

CBOs have made to the NGO sector. I have the following points in this regard

1. CBO is not to be developed but HAS TO BE EMERGED. The policy and strategies

of NACO, SACS and NGOs are to be into this direction. A CBO that has emerged

would definitely perfor better than the one that has been developed by an

external force

2. The reality that CBOs are targeting the priority needs and issues of the

community is true and it is RIGHT. Unless the community addresses this who else

will do that? More than that addrssing the priority issues like stigma and

empowering the community shall enable the members of the community to practice

self protection and positive prevention efectively.

3. The initiatives from PLHIV network in India is commendable. The Contribution

by the PLHIV network is successful in positive living and ART adherance of many

PLHIVs that cosiderably brings down the government expenditure on care and

treatment.

4. The capacity building and monitoring / mentoring support to be given to CBO

run prorams have to be very competent. The initiative of Tamilnadu State AIDS

Control Society to provide ongoing mentoring support to Drop in centers run by

PLHIV -CBOs is an excellant model in this

5. In Kerala, I played key role in ensuring the transfer of ownership of the

Targeted Intervention program to the FSW and MSM CBOs. In the last annual

evaluation process it has come up that the performance of the CBO run projects

are as good as NGO run ones

Let's conclude that, CBOs need more resources in the initial phase to ensure

adequate fuctioning. Once they are supported to come to the better performance

level, then it would be definetly more cost effective and better performing

Good Wishes

Dr.S.K.Harikumar

Behavior Physician & Director,

CARB & S.K.Consultancy

TC IX /1922, Kochar Road

Shasthamangalam . P.O, Trivandrum - 695010

Tel- 0471-2723982(Off)- 0471-2363982 (Res)- 09447034038 (Mob)

[Guest guest]

Dear FORUM,

/message/10606

NACO’s CBO policy is something to be appreciated, which is the result

of the struggling voices of the most vulnerable to HIV and HIV

affected people.

Shaligram’s view is typical of the general attitude of the privileged.  HIV

programs provided much opportunity for voicing

the rights of the affected people, in contrast to the conventional

provider-driven approach in health programs.

It is well recognized that health is not only a science, but a political issue

too. Science has its merits and experts have a role in policy decisions, health

care delivery and health communication.

But there is a limitation when it comes to the acceptance and benefits to

community. That is the reason for the acceptance of community participation in

public health.

Each sector should know its boundary and limitation. NACO’s CBO policy is

towards this direction. It is the sensitivity of the sector to the other and

synergy made, which make the difference

In the arena of HIV, the community is stigmatized and abjected. Since

the virus is transmitted through sexual contact and sex is a taboo

subject, experts can do very little in the control of epidemic. At the same time

communities are not accepted in the society.

In this situation, it is difficult to separate HIV issue and other issues from

the perspective of the suffering individual. For the community it is the

struggle for existence whether it is related to HIV related death or violence

from society.

How can a health program ignore the context and isolate HIV control as a

separate entity? What is the “proper work” in HIV? How is it determined and who

is doing it? It is very difficult to measure.

But one thing is sure that, HIV prevalence is low where economic condition is

good, sexuality is no more hidden and criminalized.

Regarding resources, it has become a custom that ultimately resources

will reach experts in the name of capacity building or training or any other.

Even when there is community based approach, if we analyze the distribution of

resources, we can see the difference.

“Knowledge” is a tool for retaining power within the hands of those who are

trained conventionally. But the practical “knowledge” acquired by people through

their life experiences is not counted as “knowledge.”

In the health programs including HIV programs where the stigmatized

population is included, much time from the community is taken by

experts for preparing modules etc. It seems that there is no value for the “time

of community members”.

They would be losing their working time and also often they take the risk of

being further stigmatized.

Money given to community is described as “wastage”. It is also stated

that now poor people are having more money. It blatantly shows the

intolerability of change in the status quo of people which is

maintained by institutions, programs and policies.

Is it a crime to acquire more money? Corruption is different. If there is

corruption, that has to be addressed in a different way.

That is not because of the policy change encouraging CBOs.

Corruption is seen every where. But when it is seen among uneducated poor

people, it is interpreted as the characteristic of that particular community,

not as a crime by that particular person.

Is it MSM community trying to get separated from society or society

excluding them?

For people who are denied of resources, the first need is resource itself. If

money is valuable, everybody will struggle for

it.

It is the responsibility of experts and others to design the

programs, considering the situatedness of the community. There is no

point in blaming the victims.

Regards

Dr. Jayasree. A.K

e-mail: <akjayasree@...>

[Guest guest]

Dear all

Re: /message/10606

Let me thank you all for the reply and comments on my posting on NACO’s CBO

policy.

I am working with MSM communities and also PLHIV communities for last six years.

i expect the results for communities. in the PLHIV communities there are very

big issues, such as the needs of women especially widows, their children. The

issue like stigma and discrimination is also huge.

Then the question arise here, though the CBOs are working at districts to

taluka levels then why this issues are still remain?

Is it the CBO goal to make this communities economically sound? The answer is

no. The goal of CBO policy should be that to normalize these communities in

general society at large

I agree with you that overall the CBO policy is RIGHT. In many places this

policy is working very effectively and giving the positive results.

i also accept that the CBO policy has helped many groups and the results are

good. The policy has helped them to empower and strengthen many CBS with

sustainable programmes.

But still there are problems which need attention from NACO. The following are

some of my suggestions

1. Many of the CBO members want the SEPARATION from general society

2. Even though we believe on that the CBO leaders will support the community,

often it is not TRUE. Unfortunately many are USING their STATUS for their own

benefits only.

3. In many CBOs only the FOLLOWERS of the CBO leaders are given the chances on

the bodies of the CBOs especially PLHIV networks

4. It seems the CBO policy is indirectly supporting to the MSM behavior and they

are neglecting the general society

SUGGESTIONS

1. We need to initiate a RESEARCH STUDY on all above issues, how effective is

the CBO policy?

Good wishes

Shaligram

Shaligram Kamble

e-mail: <shaligramkamble@...>

[Guest guest]

Dear Forum

I strongly agree with Jayashree. I have seen quite a few CBO's which deserve

direct funding from SACS/ NACO. Their commitment, insight, outreach to community

and cost effectiveness cannot be matched by the International and National

NGO's.

It is justified that community is seen as an expert and compensated fairly.

At the same time, It is imperative investments are made in building systems and

capacities of CBO's, to ensure they succeed, especially since there are several

individuals and organisations, who are hoping this bold initiative of NACO,

built on the foundation of community struggles fails. For this CBO support

services should be  provided to CBO's who are the front line of battle against

AIDS.

sincerely,

Pankaj

[Guest guest]

Dear Shaligram,

I am glad that you are narrowing down the issue, which stems from your

experience of working with MSM and PLHIV.

Addressing stigma and discrimination is by no means a simple process.  One has

to deal with prejudices of the society at large.  If your strategies for

reducing the stigma are not working then you need to seriously introspect about

your strategies and change them.  We all learn from what goes wrong.  If

everything went correct in the first place where the learning will come from?

On MSM issues you say many of the CBO members want separation.  They want

separation from whom?  Society or the NGOs?  This is not clear from your mail as

two are separate issues.

If the separation is from NGO - i agree with that as I do not see why people who

are from the community cannot manage the interventions?  I am by no means

suggesting that put the interventions in the hands of incompetent people.  But

find the competent or build their capacity and give them adequate compensation

so that they can manage their own interventions.  I do not see any conflict in

this.

If the issue is that MSM want to separate from General Society, there is a need

to introspection from all as to what is making marginalized communities to

remain marginalized?  Answers would be simple - non acceptance, stigma and

discrimination, invisible discrimination.

I have often asked this question to lot of organizations - how many people do

they employ who are transgender?  I have come across very few organizations

doing that.  Same goes for other groups as well. 

Again i repeat i am not suggesting take incompetent people.  What i am saying is

that there are competent people amongst these groups as well.  Yet visible and

meaningful involvement is little.

Most of industrial houses still do not employ PLHIV.  Openly MSM (Gay / Bi /

Transgender) people are often ridiculed and discriminated against in work

places. I have once lost a job because i was open about my sexuality.

On the issue of Leadership, well there are always good and bad leaders every

where.  That does not make the whole community bad.  Otherwise with the kind of

rotten eggs we have in our parliament, the whole country would be termed bad. 

Is that the right thing to  do?

Hope i have been able to contribute to the discussion that you have started.

Warm Regards,

Rajiv

e-mail: rajivdua@...

[Guest guest]

Dear FORUM,

Re: /message/10606

I also want to point out that while there were 2 seperate types of funding that

were agreed to in the NACP-3, namely one for NGO MSM interventions, and another

for MSM CBO interventions, SACS are refusing to give the CBO interventions funds

to CBOs (Which is more than NGO intervention funds).

They insist that CBOs should also take only the NGO intervention funds and no

more. The whole logic of strenghtening communituies by giving them extra support

is totally lost in this.

This is certainly true in the case of the Delhi SACS. So if this can happen

right under the noses of the NACO in Delhi itself, one can imagine what it is

like in oter places.

I am also still to understand what was the criteria that was followed by Delhi

SACS hen they gave out all the MSM interventions to various NGOs and CBOs.

Especially the logic in giving it to Church Based Organisations who

are still talking about changing the MSM into straights and propogating a highly

moralistic and stigmatising attitute towards MSM.

Best regards,

Aditya B

Aditya Bondyopadhyay

E-MAIL: <adit.bond@...>