1999_2_tanzania



	Sexual Health Exchange, 1999 - no. 2 Tanzania The TANESA Project has developed an easily replicable "mapping" intervention to assist communities in identifying and addressing risk situations for HIV/STD infection and sexual violence. The intervention is low cost because it only requires input from professional staff in the initial stages. Development and agricultural extension workers train one woman/girl and one man/boy from each ward in their district (the wards usually comprise about five villages that together represent 25 communities). These newly-trained volunteers in turn train one woman and one man from each village. The ward counsellor and executive officers actively promote community involvement throughout the process. During the intervention, separate groups of men, women and youth are asked to draw maps of their communities and to indicate the places where they feel they are at risk or may practise risky sexual behaviour. For instance, men might mention bars, guesthouses, hotels and traditional dances. Women and girls may mention other places, such as where they collect water and firewood (because they are vulnerable to rape there) and schools (because girls are abused by male teachers). Women promoting condom use during a campaign usign the mapping exercise After completing the maps, the participants discuss the problems men and women face in avoiding the identified risk situations and behaviours. These might include, for example, drinking habits and alcoholism, exchanging sex for gifts and money, lack of condoms, insufficient community sanctions against sexual abuse and violence, a lack of parental guidance for youth or fathers' participation in educating (rather than just punishing) their children. They also discuss ways to change these situations. The groups then present their problems to one another and explain their proposed solutions. Together they can prioritise the possible solutions and discuss these with community leaders so that the community at large takes action. Examples of solutions proposed in Tanzania have included: encourage men to avoid or lessen their visits to drinking places avoid having multiple sexual partners begin more incomegenerating activities so that women are not so dependent on men for income ensure that condoms are available and educate people how to use them make rape punishable establish community rules that help protect people stop women from collecting firewood and water after dark (though this may restrict women's freedom of movement, it can also contribute to gender equality if men must help them collect wood and water) forbid children and youth from entering bars and guesthouses restrict youth who are petty vendors from selling after 4:00 p.m. prohibit local beer sales until 07:30 p.m. Depending on local resources, ward counsellors may give the volunteers some incentives, such as certificates identifying them as community mobilizers. The volunteers may also be asked to participate in local radio programmes to promote the intervention and/or be invited to a districtlevel celebration in which they present the progress of their communities to one another. Community drama groups can dramatize the process as a way of disseminating results to villages. A multi-sectoral team that includes representatives of the district council, agricultural extension, community development, health and planning departments can do the follow up. Through this approach, TANESA has covered nearly 1000 communities and 380,000 people at a cost of US$ 3000. They found that: some men realize that they underestimate the need for behaviour change; women are often ready for change, but need a platform to express their fears and ideas exchange between men and women is essential to develop action; when this occurs, women often take the lead; youth should be enabled to express their own solutions; communities are able to develop culturally acceptable and gendersensitive solutions to create a supportive environment for behavioural change; community care initiatives for people living with HIV/AIDS and their families may arise out of the developed prevention activities. Venance Nyonyo & Dick Schapink, TANESA, P.O. Box 434, Mwanza, Tanzania; Tel:+255-68-500.236; Fax: +255-68-502.458; e-mail: tanesa@tan2.healthnet.org or dickschap@mbio.net and Maria de Bruyn, Ipas, 300 Market Street, Suite 200A, Chapel Hill, NC 27514, USA; Tel: 1-919-960.5548; Fax: 1-919-929.7687; e-mail: debruynm@ipas.org.
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