The HIV/AIDS Challenge in Africa An Impact and Response Assessment The Case of Botswana
Table Of Contents:
1) GENDER AND HIV/AIDS: MALE RISK AND MALE SECTOR INTERVENTIONS IN BOTSWANA Godisang B. Mookodi and Tapologo Maunden
2) SOCIO-ECONOMIC IMPACT OF HIV/AIDS ON RURAL SMALL-SCALE INDUSTRIAL SUB-SECTOR: THE CASE OF SELECTED VILLAGES IN BOTSWANA Stephen M. Kapunda
GENDER AND HIV/AIDS: MALE RISK AND MALE SECTOR INTERVENTIONS IN BOTSWANA Godisang B. Mookodi and Tapologo Maunden
We thank OSSREA for funding this project. The project would not have been implemented without the institutional support provided by the University of Botswana for which we are grateful. Our study illustrates the importance of forging and strengthening links between academic researchers and community-based practitioners. We take this opportunity to thank our research partners in – the Men, Sex and AIDS programme: Lopang Raboloko, Macdonald Maswabi and Moabi Mosekiemang. We also thank the Men, Sex and AIDS officers in Kasane: Messrs. Rahii and Rapula. During our report writing, we learned that the Men, Sex and AIDS programme was being discontinued. The absence of this organization will leave a large gap in the male intervention sector. It is our sincere hope that this report will assist in strengthening the male intervention sector in Botswana. We thank our research assistants: William Keareng, Modisaotsile Thapelo, Monkgogi Lenao and Gorata Gopolang for all the hard work they put into data collection and transcription. Last, but certainly not least, we thank our families for their unwavering support and patience.
UNAIDS estimates indicate that one out of every four adults in Botswana is infected with HIV. The Botswana 2003 HIV Surveillance Report shows the overall HIV prevalence in the country to be as high as 37.4%. The rapid spread of HIV/AIDS has prompted researchers and practitioners to address the problem of unsafe sex practices and behavioural change. Most of the research and interventions on gender and HIV/AIDS in Botswana have focused on women. This focus on women stems from the recognition of culturally-based entrenched patriarchal practices that prevent women from negotiating safe sexual practices. The increase in infection rates shows that prevention interventions have not resulted in behavioural change.
On the basis of UNFPA’s (and other) new approaches to sexual and reproductive health, the government of Botswana’s national HIV/AIDS strategic framework for 2003-2009 has stressed the need to focus on men in HIV/AIDS prevention strategies. The government has developed a male sector response that targets the defence force, police service, immigration and the prisons department. Civil society organizations such as Men, Sex and AIDS, and the Society of Men Against AIDS in Botswana have been targeting men through various information, education and communication (IEC) activities. These interventions are not informed by research on men’s lives. There are no locally-developed theoretical and conceptual frameworks that either inform discourses on masculinities or male-focused interventions in Botswana.
The primary aim of this research was to assess male involvement and male sector interventions in prevention of HIV/AIDS transmission in Botswana. The study was conducted in collaboration with the Men, Sex and AIDS Programme in Botswana. The assessment focused on: a) assessing the socio-cultural and economic factors that place males at risk of HIV infection; b) examining the approaches and methods utilized by the various stakeholders in their work with males – particularly with respect to curbing risk behaviour and promoting male involvement c) discussing the impact of the interventions with target groups d) identifying the successes and challenges faced by male sector interventions in Botswana. The fieldwork was conducted in 2005. The study was qualitative – respondents included individual males, males in focus group discussions and key informants in male-based organisations as well as those that focus on gender and HIV/AIDS in Gaborone, Kasane and Maunatlala.
The study found that the following socio-cultural factors place males at risk of HIV infection: the way males learn about sexuality issues; materially-based motivations for entering into relationships by women and men; the relative absence of community and family-based male socialization agents; and inadequate knowledge about HIV/AIDS. While the respondents pointed to the vulnerability of females to infection, they did not view themselves, and their behaviour as putting them at risk of HIV infection. The study further found that most approaches and methods utilized by stakeholders who work in the area of males and HIV/AIDS are top-down, and are not informed by research on masculinities. The study also found that no research had been conducted to evaluate the impact of existing male focused interventions. What was clear was that a majority of respondents were not aware of existing male interventions that focused on HIV prevention in the country.
Lastly, the study found that stakeholders faced numerous challenges. These include: lack of funds; community resistance to educating young people about sexuality issues; alcoholism; community beliefs and misconceptions; difficulties in measuring behaviour change and no regular collaboration among stakeholders. Nevertheless, stakeholders highlighted some successes including: condom distribution; fundraising and charity work; dialoguing and networking with various groups about sexuality issues; effective public education programs; establishment of abstinence groups and establishment of youth friendly services.
SOCIO-ECONOMIC IMPACT OF HIV/AIDS ON RURAL SMALL-SCALE INDUSTRIAL SUB-SECTOR: THE CASE OF SELECTED VILLAGES IN BOTSWANA Stephen M. Kapunda
The general objective of the study was to examine the socio-economic impact of HIV/AIDS on small-scale industrial enterprises in selected rural areas of Botswana. These enterprises were considered to be important in rural industrialisation and poverty alleviation.
The aspects looked into included labour force and productivity growth; costs and profitability trends; management performance; and HIV/AIDS policies and educational programmes.
Although the methodology involved the use of both primary and secondary data, and the study, however, used mainly primary data collected from a survey conducted by the researcher between March and October 2005 using interviews and a revised questionnaire prepared after a pilot study.
The main survey was conducted in 66 small-scale enterprises drawn randomly from three villages: Mochudi, Tonota and Masunga. The villages were selected in such a way that they included variety of economic activities. Other considerations included variations in population density, infrastructure development and distances from the capital city – Gaborone.
In general, despite the paucity of relevant data the study found that the impact of the pandemic was generally adverse on all examined dimensions.
The impact of the pandemic on the very small enterprises was more pronounced than was the case of the enterprises employing 5 – 25 workers. Since these firms were mainly managed by women and the youth the amplified impact was felt by particularly women, children and the youth.
The specific findings were as follows:
(i) Slightly above one-third (37 per cent) of all small-scale enterprises reported incidence of HIV/AIDS among some of the employees: 15 per cent indicated low HIV/AIDS incidence; 13 per cent expressed moderate incidence, while 9 per cent considered the incidence high at workplace.
Mochudi village enterprises reported the highest HIV/AIDS incidence (40 per cent), followed by Tonota (38 per cent) and Masunga (33 per cent).
(ii) Labour force and productivity growth was affected adversely by HIV/AIDS in at least two ways. Firstly, through morbidity problems: sickness and absenteeism due to HIV/AIDS and related problems; secondly through mortality problems:
Thirty-two per cent of the enterprises with HIV/AIDS incidences had serious cases of sickness in the past two years.
Forty per cent of the firm enterprises with HIV/AIDS incidences perceived serious problems of absenteeism in the period.
Twenty-four per cent of such enterprises had cases of death among their employees in that period.
For the enterprises with HIV/AIDS incidences, average productivity of labour decreased by an average of about four per cent between 2004 and 2005; while for those enterprises without the pandemic incidence productivity increased by about five per cent in the period.
For the very small (micro) enterprises with HIV/AIDS incidences productivity fell by eight per cent, whereas, in those enterprises without the pandemic incidences productivity increased by one per cent.
(iii) Normal costs due to the pandemic: transport costs and funeral costs were not substantial to the small-scale enterprises in general as relatives and friends took care of the burden in most cases.
(iv) Regarding profitability, 96 per cent of all enterprises with HIV/AIDS incidence perceived that profitability was adversely affected by the pandemic. In Tonota and Masunga all enterprises with HIV/AIDS incidence expressed that profitability was negatively affected by AIDS. Twenty-four per cent of all enterprises with HIV/AIDS incidence expressed high or serious impact of AIDS on profitability.
(v) Management performance was also affected by the pandemic. The following problems were pointed out by various managements:
Refusal of some workers/employees living with the HIV/AIDS virus to be transferred to sections which management considered suitable for them;
Difficulties in handling absentees due to the pandemic; and Difficulties in dealing with some of the workers living with HIV virus.
The study also indicated that 12 per cent of the enterprises that reported to have had HIV/AIDS incidences revealed cases of death of some management staff. The respective percentages in Mochudi, Tonota and Masunga were 8, 12 and 20. In Tonota and Masunga very small enterprises (employing three – four workers) reported such cases, and hence general performance was affected here more, than in the enterprises employing more than five workers.
(vi) It was also found that only nine per cent of the 66 enterprises had documented HIV/AIDS policies and 12 per cent had educational programmes relevant to HIV/AIDS. Most of the enterprises with HIV/AIDS policies and programmes were from Mochudi. Possible reasons for this include the existence of many enterprises with relatively large number of employees (more than 15) in Mochudi and Gaborone cities – proximity to and influence of awareness and recognition of the importance of HIV/AIDS policies and programmes. Only about half of the enterprises with HIV/AIDS policies showed evidence of implementation of their programmes. The most frequently provided reason for enterprises without the documents was that there was no need at that time to have such policies in small enterprises. They also perceived that it was unprofitable to have such enterprises. Furthermore, a few of the enterprises expressed that HIV/AIDS problems should be handled by the individual employees.
However, about three-quarters of the enterprises without HIV/AIDS policies and programmes attempted to educate workers through meetings, organised discussion, wall charts and the like.