Nair Yugi, Campbell Catherine
Afr J AIDS Res. 2008 May;7(1):45-53. doi: 10.2989/AJAR.2008.7.1.6.434.
The importance of partnerships between marginalised communities and support agencies (from the public sector, private sector and civil society) is a pillar of HIV/AIDS management policy. Such alliances are notoriously difficult to promote and sustain. We present a case study focusing on the first stage of a project seeking to build partnerships to facilitate local responses to HIV/AIDS in a remote rural community in South Africa. To date the Entabeni project has been successful in its goal of training volunteer health workers in home-based care, peer education, project management and procedures for accessing grants and services. The paper focuses on the project's other goal - to create external support structures for these volunteers (drawing on government departments, local NGOs and private-sector philanthropists). The partnership aims to empower volunteers to lead HIV-prevention and AIDS-care efforts, and to make public services more responsive to local needs. We illustrate how features of the local public-sector environment have actively worked against effective community empowerment. These include a rigid hierarchy, poor communication between senior and junior health professionals, lack of social development skills and the demoralisation and/or exhaustion of public servants dealing with multiple social problems in under-resourced settings. We outline the obstacles that have prevented private-sector involvement, suggesting a degree of scepticism about the potential for private-sector contributions to development in remote areas. We discuss how the project's most effective partners have been two small under-funded NGOs - run by highly committed individuals with a keen understanding of social-development principles, flexible working styles and a willingness to work hard for small gains. Despite many challenges, the partnership formation process has seen some positive achievements; we outline these and discuss the essential role played by an external change agent, and conclude with a discussion of the possibility of building long-term structures to sustain the project.
边缘化社区与支持机构（来自公共部门、私营部门和民间社会）之间建立伙伴关系的重要性是艾滋病毒/艾滋病管理政策的一大支柱。众所周知，此类联盟很难推动和维持。我们呈现了一个案例研究，聚焦于一个项目的第一阶段，该项目旨在建立伙伴关系，以促进南非一个偏远农村社区针对艾滋病毒/艾滋病的本地应对措施。到目前为止，恩塔贝尼项目在其培训志愿卫生工作者进行居家护理、同伴教育、项目管理以及获取补助金和服务程序的目标方面取得了成功。本文聚焦于该项目的另一个目标——为这些志愿者建立外部支持架构（借助政府部门、当地非政府组织和私营部门慈善家的力量）。该伙伴关系旨在增强志愿者引领艾滋病毒预防和艾滋病护理工作的能力，并使公共服务更能响应当地需求。我们阐述了当地公共部门环境的特征是如何积极阻碍有效社区赋权的。这些特征包括严格的等级制度、高级和初级卫生专业人员之间沟通不畅、缺乏社会发展技能，以及在资源匮乏环境中应对多种社会问题的公务员士气低落和/或疲惫不堪。我们概述了阻碍私营部门参与的障碍，表明对私营部门为偏远地区发展做出贡献的潜力存在一定程度的怀疑。我们讨论了该项目最有效的伙伴是两个资金不足的小型非政府组织——由高度敬业的个人运营，他们深刻理解社会发展原则，工作方式灵活，愿意为小的成果努力工作。尽管面临诸多挑战，但伙伴关系形成过程已取得一些积极成果；我们概述了这些成果，并讨论了外部变革推动者所发挥的关键作用，最后讨论了建立长期架构以维持该项目的可能性。
