2004-1 Partnering with faith-based

Sexual Health Exchange 2004-1

Partnering with faith-based organisations to address HIV/AIDS in Malawi

Ethel Kapyepye & Christo Greyling

World Vision Malawi (WVM) is a Christian development organisation that has been working with rural communities in Malawi for 22 years. Realising that these communities have been impacted heavily by HIV/AIDS, the organisation felt compelled to address HIV/AIDS through a Christian response. WVM has been working in partnership with church- and faith-based organisations in development work and as such it was easier to integrate HIV/AIDS in the already existing programmes. Staff realised from the onset that religious leaders have been slow in embracing HIV/AIDS due to the sensitivity surrounding HIV. Quite often, this silence was caused by direct religious association between HIV and immorality in the form of certain sexual behaviours, sexual orientation, and drug and alcohol use. They also realised that most of the religious leaders and their institutions lack capacity to be able to respond effectively to HIV/AIDS. WVM therefore started a capacity building programme for FBOs in 2001.

Just like other countries in sub-Saharan Africa, Malawi has been severely affected by HIV/AIDS. Although there are signs that the HIV prevalence is going down – the infection level among young women (15-24 years) attending antenatal clinics in Lilongwe has declined from about 26% in 1996 to 16% today – Malawi is still a high-prevalence country. In 2003, the National AIDS Commission estimated that overall HIV prevalence in adults aged 15-49 years is 14.4%. The epidemic in Malawi has affected all sectors of the society. The economic viability of most homes has deteriorated due to the loss of breadwinners and the consequent support of orphans by their siblings and the elderly.

The population of Malawi is diverse in terms of language, religion and ethnicity. According to the last census conducted in 1998, 80% of the population are Christians and 13% Moslems, 4% follow no religion and 3% reported to follow a religion other than Islam or Christianity, including Hinduism and African traditional beliefs. As the majority of Malawians are Christians, the response of the faith-based sector to HIV/AIDS is primarily Christian as well.

WVM's capacity building programme

The goal of WVM's programme for FBOs is to mobilise and provide technical capacity to FBOs at national and community levels. Through the programme these organisations learn to effectively address HIV/AIDS within their congregations and communities.

At the national level, WVM:

vHas represented FBOs from the grassroots in a multi-faith committee known as the State/Faith Committee on HIV/AIDS, which meets regularly to look at policy and technical issues regarding HIV/AIDS. This committee, comprising religious leaders, government officials and the National AIDS Commission, also looks at resource mobilisation for the district and regional coalitions. The National AIDS Commission supports the meetings financially.

vConducted three regional workshops that looked at issues on involvement of faith communities in HIV/AIDS work. These workshops drew representatives from district congregations and coalitions. They identified reasons why the faith community was not yet involved and how they were going to be involved in prevention, care and advocacy. The workshops were a collaborative effort with World Relief, CHAPEL (Charismatic and Pentecostal Churches Association), WVM and the National AIDS Commission.

At the community level, WVM:

vHas facilitated the formation of coalitions of CBOs and FBOs on HIV/AIDS and linking them to the district and regional coalitions. This has strengthened the lower level coalitions and facilitated access to resources and technical support.

vHas used the ‘Churches, Channels of Hope' mobilising workshop model to empower faith leaders to change their attitudes, understand the basic facts about HIV/AIDS and move from judgement to compassionate action (see side-box).

vHas supported capacity building of FBO members who have tested HIV positive and have come out. As a result the PLWHA are giving personal testimonies of their experiences in living with the virus at the workshops and they are also serving key roles in the church.

vHas worked with some churches and linked them with donors that are providing financial resources, and gifts in kind.

vHas aided the faith communities in the development of action plans on HIV/AIDS. These action plans have been funded locally or with outside support.

Lessons learned

WVM has learned a great deal through its interaction with faith leaders. First, condom use is still a thorny issue but some leaders are appreciating the role of condoms in HIV prevention, especially for couples of whom one partner is HIV positive and for couples who are involved in risky behaviours. For example when we begin the workshops, participants are adamant that condoms are not for Christians but as we go into day two and three these are some of the expressions heard: "‘It is not because I have a problem with condoms myself, I want to understand so that I can explain better when I get back to my congregation", and "As Christians we cannot promote them in the church but we will refer our members to the clinics because we know condoms can be useful to prevent transmission of the virus in married couples, this is something we did not know."

Second, the voices of FBO representatives who are open about their status and have given their testimonies have added to reduce stigma and discrimination within the faith communities, resulting in more acceptance of PLWHA and willingness to talk about HIV prevention and care. This is witnessed in more churches and faith communities talking about HIV/AIDS, participation in World AIDS Day activities that are not stigmatising, and involvement in counselling and support.

Another lesson learned is that one of the reasons FBOs were not very much involved in HIV/AIDS prevention, care and advocacy has been the lack of technical capacity and resources to respond effectively. Once the leaders undergo the training a marked improvement in their response has been observed. For instance, at the beginning of the workshop participants share what they do and this is in agreement with existing data at the district level: most FBOs restrict themselves to care of the sick and orphans. By the time they have finished the workshop they realise that as faith leaders they have a big role to play in prevention (focusing on abstinence and mutual faithfulness) as well. Work plans and supervisory visits after the workshop show this change in attitude.

Finally, linkages with other FBOs at community, regional and national level has enabled the faith leaders to learn from each other and appreciate the fact that they are facing similar challenges and can share lessons on how to handle these challenges regardless of faith.

Challenges

Most of the districts have no district network/coalition for faith organisations. These networks are important tools for mobilisation of FBOs around access to funding, and technical and other support. Stakeholders like WVM should work together to help the churches/FBOs move towards increased networking. In Malawi these coalitions should be linked to the District AIDS Coordinating Committee, which in turn is linked to the District Assembly, which is distributing all the district funding.

Another challenge is the capacity of FBOs, especially those in the rural areas, to keep records of finances and activities. This is an area where WVM and other partners should put more effort in; to put in place ways of assisting these organisations so that they can gain the confidence of donors. With the coming of the Global Fund and other funding opportunities it is indispensable that FBOs are ready to absorb and account for this funding.

Ethel Kapyepye, National HIV/AIDS Coordinator World Vision Malawi; P.O. Box 692, Lilongwe, Malawi; tel.: +265-1-75.62.94/75.64.84/75.43.17, cell: +265-8-84.33.70, e-mail: ethel_kapyepye@wvi.org; and Reverend Christo Greyling, Africa Regional HIV/AIDS/Church Relations Advisor World Vision International; tel:.+27-11-671.14.21, cell: +27-82-450.70.98, e-mail: christo_greyling@wvi.org

World Vision's mobilisation of local congregations: a two-step model

1. Start with local religious leaders

Religious leaders from all faith communities are key "door-openers". Faith leaders know they should respond to HIV/AIDS, but they very often fail. This is due to inappropriate attitudes, direct association of HIV/AIDS with sin and promiscuity, a lack of correct information and essential skills to know how to respond. Experience has shown that religious leaders become powerful change agents when they themselves undergo a life-changing experience.

All the religious leaders from a local community are invited to attend a process-driven three-day HIV/AIDS workshop. This includes the following experiential learning elements:

vExploring the attitudes of religious leaders towards PLWHA

vEncouraging religious leaders to debate the difficult theological and ethical issues related to HIV/AIDS

vSharing up-to-date information about HIV transmission, prevention, care, and treatment

vEnabling HIV-infected and affected people to share their experiences, challenges, and hopes

vDiscussing the emotional needs of PLWHA at each phase of the illness to help religious leaders become more effective counsellors

vHelping religious leaders assess their congregations' and communities' current needs relating to HIV/AIDS

vFacilitating identification of responses to HIV/AIDS already underway by churches, FBOs, and other groups in the community and sharing successes, failures, and lessons learned

vWorking with religious leaders to develop action plans to expand prevention and care through faith groups in the community.

After the workshop, participants start to "defrost" their congregation in relation to HIV/AIDS. This is done through preaching, prayer, the use of symbols, and the way they communicate unconditional love, forgiveness and compassion.

2. Launch congregation-based AIDS workgroups

To strengthen and expand their response, well-motivated religious leaders select key people from their congregations to attend a follow-up workshop. This workshop employs similar experiential learning processes, but with special attention to:

vExposure to a variety of community-based best practice models relating to prevention strategies, care for orphans and vulnerable children, voluntary counselling and testing, advocacy and home-based care

vExposure to the experiences of faith-based organisations or congregations who have already started HIV/AIDS programmes

vDevelopment of action steps for congregational and community commitments

vCollaboration and integration with existing community initiatives, AIDS organisations and care programmes.

After these workshops for faith leaders and congregational workgroups, World Vision works to strengthen the capacity of faith groups to pursue the action plans they have developed for an HIV/AIDS response