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FAITH BASED ORGANISATIONS HIV

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FAITH BASED ORGANISATIONS HIV Powered By Docstoc
					           FAITH BASED
       ORGANISATIONS HIV/AIDS
           WORK SURVEY

             MALAWI REPORT 2003
      1.     Institutional Framework and Set-Up of FBOs


             o The National Strategic Framework in recognition of the work that
               FBOs are carrying out on HIV/AIDS in Malawi placed them as core
               implementing agencies working directly with communities. Efforts
               have been made to strengthen partnerships among religious
               organizations with regard to planning, implementation, monitoring,
               evaluation and resource mobilization.
             o There is an office responsible for religious affairs in the Office of the
               President and Cabinet.
             o In addition, religious groups have formed umbrella organizations
               including Episcopal Conference of Malawi (ECM), Moslem
               Association of Malawi (MAM), Malawi Council of Churches (MCC),
               Christian Health Association of Malawi (CHAM) and Charismatic
               and Pentecostal Association of Malawi (Chapel), under which the
               majority of FBOs operate. These umbrella organizations support
               collective coordination and collaborative efforts including planning.
               In 2001,
             o a State Faith Community Task Force was formed to enhance
               collaboration between Government and FBOs in Malawi.
             o As a follow-up to the November 2001 WCC HIV/AIDS Conference
               in Nairobi, a churches conference took place in November 2002
               where all churches and their umbrella organizations came together
               to break the silence and address the challenges of HIV/AIDS. This
               conference was a result of the cooperation of the three major
               church mother bodies of MCC, ECM and EAM in collaboration with
               the Norwegian Church Aid.


2.0        SPREAD OF FBOs IN MALAWI, GOVERNANCE AND HUMAN AND
           FINANCIAL SYSTEMS CAPACITY.


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    The mushrooming of FBOs in all parts of Malawi cannot be
     overlooked.
    . Faith leaders and their organisations are well respected and
     therefore command a strong following.
    In addition religious organisations , individually and together
     have a deep geographical penetration. This presents great
     advantages to intensifying interventions and to increasing the
     reach and impact of these interventions.
    Many FBOs have recognized governing structures. However,
     many do not open up to external professional membership of
     their governing bodies while others still remain very
     conservative with bureaucratic structures. This has dented the
     face of the FBOs as many remain very closed to open up
     particularly to books of accounts.
    The human and management systems capacity have been
     affected much by unavailability of qualified personnel in these
     institutions. However, it is seen as a common tradition in most
     FBOs recruiting unqualified personnel and in some cases based
     on ‘relationships and trust’ which has compromised quality of
     work being provided. As an example of one of the FBOs human
     resource capacity, CHAM’s current capacity of selected
     professional health workers from its 159 members is as presented
     below:


PROFESSIONAL HEALTH WORKERS IN CHAM
Cadre                        Recommended   Actual           %
Medical Officers             36            15               41.6%
Clinical Officers            102           69               67.6%
Medical Assistants           271           80               29.5%
Nurses                       1995          856              42.9%
Dental Tech/Assistants       152           10               6.6%
Laboratory Tech/Assistants   152           51               33.6%
Pharmacy Tech/Assistants     276           19               6.9%
Patient Attendants           234           413              176%

The overall picture of the staffing situation in CHAM has 7664
recommended posts of which only 4746 (61.9%) posts are filled.
Amongst the professional cadres, only 33% of the recommended
posts of the approved establishment are filled.

Several reasons are contributing to this situation which among others
are:
 Many FBOs are very rural based therefore difficult to attract
   qualified personnel.



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            Qualified personnel particularly health workers are scarce on the
             market.
            Competitive packages – other NGOs of which some are faith-
             based are providing very high perks.
            The problem of HIV/AIDS: attrition resulting from HIV/AIDS related
             deaths is very high at the moment.
            Current outputs from all health training institutions do not match
             the demand for personnel in the health sector.


1.1         INSTITUTIONAL SET UP OF FBOs
            Some FBO’s have structures for implementation of HIV/AIDS where
            coordinators/ supervisors are in place but this applies to only a few. In
            most of the FBOs, structures are just being put in place.

            In October 1999, a wide array of stakeholders in Malawi developed the
            National Strategic Framework on HIV/AIDS: 2000 – 2004 (NSF),
            outlining the national response to the epidemic.          National AIDS
            Commission (NAC) has been tasked to coordinate the national response
            including provision of policy and leadership on the issue.

            Strategies and Policies to guide activities of HIV/AIDS activties are
            found within some organizations e.g. World Relief Malawi, AHS,
            Anglican Diocese of Northern Malawi, LISAP Project (Livingstonia
            Synod) among others. Other FBOs still do not have policies/strategies
            to guide them in the endeavor to fight against HIV/AIDS.

3.0         MAJOR ACTIVITIES PURSUED BY THE CHURCHES
            In responding to the epidemic Faith Communities have addressed
            both prevention and impact mitigation. The study has strengthened
            the knowledge that FBOs are working in many areas of HIV/AIDS, trying
            to stop its spread among the children of God, but also dealing with the
            effects for the infected and affected persons.

5.2.1       EDUCATION AND TRAINING

            Prevention interventions have included information campaigns, but
            these have not been adequate in part because of judgemental
            approaches to interventions and in part as a result of emphasis on
            moral teaching.

            Almost all FBOs considered training of the providers of HIV/AIDS
            services as important. Target groups were also included in different
            training sessions of all the sub themes to equip them with knowledge,


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        skills and positive attitudes when handling HIV/AIDS issues. The number
        of training sessions for each institution depended on availability of funds,
        which determined availability of the other resources.

        All FBOs considered the importance of the clergy/sheiks and included
        them in the trainings they have conducted.

        Due to inadequate funds, some institutions trained only a few.

        From the findings, we realize that FBOs would like to conduct
        more training sessions but due to inadequate funds, some
        institutions trained only a few. Many FBOs expressed the need for
        more consistent and encompassing training programmes, with
        more emphasis on the outputs.

        Faith communities would be more effective if they at the same time
        revised their theological positions on issues of sex and sexuality.

5.2.2   ADVOCACY

        Groups of people in all FBOs are engaged in disseminating
        HIV/AIDS messages to people in their areas regardless of religious
        affiliation. Some FBOs involve target groups in planning
        programmes as this helps with ownership of the activities. The
        advocacy groups are gender based in all FBOs.

        FBOs have been called upon to collectively respond to the HIV/AIDS
        situation in Malawi. They acknowledge the need that all are present,
        actively participate in and coordinate with regional and national efforts,
        donor community and government in the fight against HIV/AIDS.The
        advocacy work is also important inside the FBOs.

        The Clergy/Sheiks still need to be oriented and re-oriented on
        HIV/AIDS issues, values and ethics and create awareness against
        stigmatization using the pulpit and other channels and teach
        people and children to break the silence on issues of sex and
        sexuality, prejudice and fear of HIV/AIDS. Many say that the issue
        of stigimatization and condemnation is still high among some
        leaders.

        Despite that some FBOs are unclear about advocacy, there are others
        who are active in FBO work.

5.2.3   ORPHAN CARE:




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        Most FBOs are providing care to orphans. All orphans in an area
        regardless of the cause of death of their parents are supported. This is
        to remove stigma and discrimination of those whose parents died from
        HIV/AIDS for example the Muslim Association of Malawi (MAM) has
        orphanage centers but the names were changed to Islamic Welfare
        Centers because the former was regarded discriminatory.

        Volunteers are providing care to orphans in centers where orphans are
        being kept. Most FBOs have trained foster families and orphans are
        being kept in the homes with other members of the families. All the
        support food, clothes, educational materials including fees is given while
        at home.

        Some programs in some FBOs are targeting the orphan families in crisis
        (OFIC) families headed by children, grandparent and sick single parent.
        The programs aim at identifying and supporting families on emergency
        basis to improve their livelihood and rehabilitate their families in a secure
        and sustainable manner.

        Due to abuse of orphans and the magnitude of the problem, many work
        through institutions even though they would have preferred a community
        based solution.

5.2.4 HOME BASED CARE

        The aim of this program is to provide care and support to people living
        with HIV/AIDS, carers and orphans. Almost all FBOs have HBC
        programs in their areas targeting the infected, other chronically ill
        patients, and the affected – guardians and vulnerable children.

        Volunteers –most women and a few men work hand in hand to take
        care of the sick people. They provide simple treatment, feed them,
        train guardians and ensure hygiene of body and environment.
        They also share the word of God to encourage positive living.

        Constraints and Challenges

        Increasing numbers of patients and orphans requiring Home
         Based Care.

        Inadequate resources – funds, materials transport for follow-up

        Reduced numbers of male volunteers.

        Increasing numbers of volunteers drop outs due to lack of
         incentives.



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            Inadequate training

            Some institutions have mentioned issue of dropouts because
             people are not able to fend for themselves while they are providing
             voluntary services to the chronically ill.

            Increased numbers of HIV/AIDS patients and orphans if VCT is not
             intensified. There will be many more people getting infected. The
             PLWAs also need a lot of counseling so that they do no infect other
             people and avoid becoming pregnant. This will reduce the number of
             babies born with HIV/AIDS. Therefore, if every FBO intensifies VCT
             services and efficiently care for PLWAs, new infections will be
             reduced. Resources to effectively provide HBC to HIV/AIDS
             patients are not adequate because they come from development
             partners and some from NAC. FBOs are not linked with others, as
             a result some FBOs have more than others. FBOs have to plan
             how they will fend for themselves in future. The numbers of male
             volunteers are small in many FBOs. There seems to be fewer
             advocacies that HBC is everyone’s role.


5.2.5       VOLUNTARY COUNSELING AND TESTING (VCT)

            Most FBOs carry out counseling services while only a few do the
            testing as well. The testing has not yet been taken to the
            communities. So far only one NGO outside the health facilities does
            testing otherwise testing is still very much clinic based making it
            unaccessible to the majority. Trained men, women and youths are
            used for counseling. Some FBOs have used VCT as a behavior
            change intervention tool, targeting males, females, orphans and
            youths e.g. The Salvation Army.          Some schools are using
            headmasters, headmistresses and teachers to counsel the students
            and other teachers.

            The counselors are advised not to scare people with HIV/AIDS
            messages. Those tested are followed up so that those who tested
            negative are encouraged to remain negative by being living responsible
            while those who tested positive are advised to have positive attitude and
            are advised how nutrition and a healthy lifestyle can assist to prolong
            their life.


5.2.6       SCREENING OF BLOOD




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        Blood is properly screened for the virus before transfusion. In
        most of CHAM hospitals blood is screened using trained personnel.

        The effort is sometimes being hindered because of inadequate
        reagents and use of untrained laboratory personnel.


5.2.7   PMTCT

        This is a program that is coming up to prevent further spread of disease
        between mother and child. A few FBOs are providing the service of
        which are five out of 159 CHAM facilities with assistance from
        UNICEF. The mothers also receive as prophylaxis isonyazide and
        bactrim. HIV positive mothers are encouraged to only breastfeed
        for the first 6 months to reduce the risk of transmission of the
        virus. This is a result of research in South Africa.

        CHAM is planning to extend this service beyond the five facilities
        currently providing the service.

        Mother to child transmission of HIV virus is a growing problem in
        Malawi that requires serious and urgent attention.


5.2.8   INFORMATION, EDUCATION AND COMMUNICATION

        Almost all FBOs print and distribute IEC materials consisting of leaflets,
        brochures, comics and booklets on HIV/AIDS to everyone regardless of
        religious affiliation and sex. Examples are World Life Ministries
        International, Evangelical Lutheran Church etc.

        HIV/AIDS messages are also disseminated during religious meetings,
        preaching sessions targeting males, females and youths. Most FBOs
        have drama and singing groups in place who take HIV/AIDS messages
        to all communities in their catchment area.

        It is pleasing to note that many FBOs are printing and distributing
        HIV/AIDS IEC materials. It is however, not known if the materials
        are of acceptable standards.

        The Faith communities have over the years conducted behaviour
        change communication activities especially for the youth. Again
        these efforts are affected by lack of adequate resources. But most
        important, teaching responsibility tends to be limited to the
        members of the clergy and those in leadership positions, excluding
        the general membership in most cases. In addition, some Faith



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        communities do not have the leaders who should project the
        appropriate models of moral behaviour.

5.2.9   TREATMENT INCLUDING ARV THERAPY

        Opportunistic infections and sexually transmitted infections are treated
        promptly and each prolongs life. Community health workers have been
        trained on how they can treat these infections. Churches/Mosques
        often promote the contribution that traditional medicine and
        wisdom can offer as a therapeutic resource. The 7 dioceses of the
        Episcopal Conference of Malawi is an example of using herbal
        medicines treatment.        Some facilities under FBOs provide
        Prophylaxis treatment of INH and Cotrimoxazole to HIV positive
        mothers with their babies. In 5 CHAM facilities, they also receive
        Niverapine.

        Collaboration is occurring in some facilities where the FBO is working in
        close cooperation with Ministry of Health and Population (MOHP) and
        MSF in treating HIV/AIDS patients. An example is Bilal Clinic in
        Chiradzulu under MAM.

        Some FBOs have reported using community health workers in treating
        Opportunistic Infections (Ols) and Sexually Transmitted Infections
        (STIs). What is not known is the competence of these people to handle
        the patients.

        It is not known if they have been given any treatment guidelines for
        treating the Ois and STIs and if they are regularly supervised by the
        FBOs. The Episcopal Conference of Malawi is using herbal medicine
        treatment on PLWAs. However, there is need to expand what the
        Episcopal Conference of Malawi is doing to other FBOs.

        ARV therapy still remains a distant hope for the majority poor
        Malawians. ARV therapy is still very much Government controlled
        and provided at a high fee of $28/month in two central hospitals
        and only one CHAM unit.

5.2.10 ABC FOR SAFE SEX PRACTICES

        All FBOs are addressing this issue to prevent further spread of
        HIV/AIDS. They encourage abstinence in a more relevant and practical
        way among youths and the importance of the “why wait” stand. The
        issue of promoting use of condoms is still difficult for the FBOs. Faith
        communities maintain a strong non-permissive position
        counterbalanced against the more ethical and rational-scientific
        position of the government. Most feel that by promoting the condoms,



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      they encourage promiscuity. There is also a reluctance to give
      information about condoms. All the FBOs talk about condoms,
      meaning the male condom. The female one is out of question. FBOs
      leaders in Malawi have started to open up the discussion, realizing
      that it contains a long row of ethical dilemmas that cannot easily be
      overlooked. They have asked for arenas to discuss the issue of
      condoms in a more holistic and gender sensitive way. Many FBO
      leaders realize that their parishioners ask for guidance about condoms
      from other NGOs.

      Adults are encouraged to have one partner and to be faithful with each
      other.

      Some FBO’s promote the use of condoms inside marriage and in cases
      of promiscuity.


5.2.11 PLWAS

      FBOs recognize and salute those people who have come out to share
      their personal counts as PLWAs. There is need to provide PLWAs with
      a safe and conducive environment where they can continue to share
      their fears, agonies, pain and emotions.

      In HIV/AIDS, it is not only the condition that hurts most, but also the
      stigma and possibility of discrimination and rejection, misunderstanding
      and loss of trust.

      Some FBOs have programs for PLWAs. Most active members are
      those living with HIV/AIDS.       They hold meetings to share
      experiences, training each other in drama and counseling
      techniques. They also encourage those who are HIV positive to live
      positively. Some FBOs have Relief and Development programs e.g.
      Word Live Ministries International under the ICOCA project, which
      has 500 beneficiaries. They give each one of them 25Kg Maize per
      month and 5Kg beans/month. Maize and legumes have been grown to
      distribute to beneficiaries.

      It is unison among the FBOs that PLWAs must not be discriminated
      against; they as everyone else must be loved, shown compassion
      and be supported in a holistic way physically. Spiritually, they
      must be given comforting word of God.              Clergy/Sheiks are
      encouraged not to preach stigma to PLWAs but to use PLWAs in all
      activities of the church. It is acknowledged that there are still many
      elements of stigmatization of PLWAs inside the FBOs.




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5.2.12 YOUTH ACTIVITIES

      Young people are the most vulnerable to the HIV/AIDS epidemic. About
      46% of all new adult infections occur in youths aged 15-24. Of these, 66
      % are young women. Peer pressure, certain cultural practices and
      limited access to information about sexual and reproductive health risk
      them to HIV/AIDS.

      Most FBOs have programs for youths. They encourage them to
      form anti-Aids clubs. Youth out of school train members and
      teachers on anti-Aids clubs. They provide recreational materials to
      the groups.

      They share HIV/AIDS information during youth meetings,
      campouts, rallies, and retreats. The main focus is on behavior
      change. An example could be the SDA church that reaches several
      thousand youths every year through drama and radio plays.

      Some youths are trained to share with others HIV/AIDS messages, train
      peer educators in life skills, and supervise educators in drama. They
      encourage each other on abstinence.            This most outreaching
      programmes are found within the members of EAM.

      However, it has been observed that the issue of youth has not been fully
      addressed in the questionnaires. There is a general lack of adequate
      programs directed towards this most important group of
      Malawians, our window of hope.

5.2.13 GENDER/MAINSTREAMING

      In Malawi, men make most decisions and women are viewed to be
      inferior and hold lower status in society. This is enforced and
      worse in the FBOs.

      Some FBOs have started involving both men and women in activities of
      the church and community. In orphan and home based care, groups of
      men and women work together. Some FBOs have aimed at having
      equal numbers of males and females in groups and have moved away
      from specific women’s programs. Some FBOs have allocated specific
      activities to specific departments of the church in order to empower
      everybody. Some FBOs have girl’s brigades with special activities.
      HIV/AIDS messages and activities are shared with them.

      Gender mainstreaming assists to have activities of HIV/AIDS to the
      grassroots and should be expanded. It is a long way for the FBOs to



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          have a gender sensitive approach in their programs. Most of them
          seem to have no idea of what the term gender means.


5.2.14 PROGRAMS TARGETING WOMEN

          Women and the girl child are more vulnerable of getting infected by the
          HIV virus and other sexually transmitted infections owing to their
          positions in society. Some FBOs have programs targeting women and
          the girl child.

          There are Women Ministry departments where among other things,
          HIV/AIDS issues are discussed. Training and empowerment is
          done where women are involved in incoming generating activities.
          Also they discuss empowerment to fight the disease and to
          empower the girl child to say No to casual sex.

          This work will only succeed if men are sensitized in the same way
          and start to take care of their young boys and girls and guide them
          properly.


5.2.15    ADDRESSING HARMFUL CULTURAL TRADITIONS AND
          PRACTICES.

          Some harmful cultural traditions and practices have lead to the spread of
          HIV/AIDS amongst people especially women and youths e.g. Chokolo,
          kuchotsa fumbi and fisi. Some FBOs are working with traditional
          leaders to take a leading role in finding alternative harmless rituals
          at initiation ceremonies for youths to reduce spread of HIV/AIDS.
          The practice of herbal cleansing is becoming popular in some
          areas as opposed to sexual cleansing. Many FBOs are working with
          traditional leaders and some materials targeting traditional
          authorities are being developed. Workshops have been held with
          traditional leaders, healers, elderly men and women on HIV/AIDS.

6.0      CHALLENGES/WEAKNESSES

         FBOs are active in the fight against HIV/AIDS and are implementing
         a number of HIV/AIDS programmes at common level. However, they
         are still grappling with challenges such as:

               High turnover of Counselors and Volunteers
               Inadequate technical staff such as clinicians, nurses and
                Laboratory Technicians.




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       Lack of specialized personnel with skills in behaviour
        change.
       Capacity in operational research, rights based approaches to
        HIV/AIDS programming, mainstreaming gender in HIV/AIDS
        programmes, planning, management, monitoring and
        evaluation of HIV/AIDS programmes is also limited
       Coordination of HIV/AIDS training and capacity building of
        local training institutions is critical for sustainable capacity
        building.
       Harmful cultural practices which are health hazards e.g.
        wasting dead bodies.
       Poor information management system at all levels and poor
        information sharing. Documentation of activities and use of
        research information I for planning and decision making is
        still very poor in Malawi
       Poor collaboration with some international organizations who
        often bypass umbrella organizations resulting in duplication
        and work overload for member units.
       Donor conditionalities. Some development partners are not
        interested     in   certain    HIV/AIDS      interventions  e.g.
        ARVS,PMTCT.
       Inadequate resources at implementation level
       Poor infection prevention practices at health facilities and
        community level.
       Compartmentalization of activities of the health facilities
        which makes sharing of resources difficult.
       Inadequate youth friendly activities and services.

KEY CONSTRAINTS              TO     IMPLEMENTATION       OF   HIV/AIDS
ACTIVITIES

         Considerable overt resistance still exists with regard to
          certain methods of HIV prevention and reproductive health
          e.g. condoms.
         Absence of an effective national coordination mechanism
          for collaborating with FBOs as a group.
         Limited participation of men in FBO activities, such as care
          and support activities.
         Limited resources allocated to FBOs (especially by
          international partners) commensurate with their scope of
          work.
         FBOs frequently do not have the human resource and
          technical capacity required to meet the complexity and
          challenges of implementing HIV/AIDS activities.




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                      While FBOs have increased support for PLWHAs, changes
                       in language and behaviour which cause despair and
                       negative attitudes remain a challenge.
                      Lack of understanding of mainstreaming gender and rights
                       in FBOs.


7.0         A SWOT ANALYSIS OF FBOs IN MALAWI

Strengths                      Weaknesses             Opportunities       Threats
 Dedicated/committed           Lack of qualified     Community          Donor fatigue.
   staff.                        personnel.             participation      Labour market
 Church has                    Recruitment of         .                    very small for
   strongest roots,              unqualified staff.    Spirit of            qualified
   linkages and longest         Programmes not         volunteeris          personnel.
   existing community            totally linked and     m in               Competition
   with formal                   integrated with        surrounding          caused by
   management and                each other.            communitie           international
   governance                   Competition            s.                   FBOs inflicted
   structures.                   amongst FBOs.         Political will.      upon local FBOs.
 Strong programme              Conservative/rigid    Government         High attrition of
   implementation                governance             interest to          staff resulting
   background.                   structures.            support              from HIV/AIDS,
 Holistic care.                Difficult to           FBOs in              greener
 National wide                  disclose financial     HIV/AIDS             pastures.
   coverage.                     resources.             activities.        Natural
 Deep geographical             Lack of use of IT     Donor                disasters,
   coverage                      to help M & E and      interest and         drought.
 Well respected and             accountability.        trust in           Unstable micro
   command a large              Donor                  FBOs.                and macro
   following                     dependency/           Peaceful             economic
 Better quality of care         Lack of local          working              environment.
 Willingness to care            resources.             environment        Unfriendly
   for the suffering with       Poor salary            .                    external/foreign
   compassion                    structure.                                  policies.
                                                                           Donor
                                                                             conditionalities.

      8.0         LESSONS/BEST PRACTICES

                  Participation of communities, particularly local leaders is vital
                   at all levels of the project cycle.
                  Consultation and collaboration must have no limit (with all
                   stakeholders)
                  Involving PLWA in IEC activities helps to reduce fear stigma
                   and discrimination in addition to those involved.


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              Persons living with HIV/AIDS have been involved in AIDS
               service organizations as staff persons, volunteers and board
               members. In some localities, HIV-positive persons have set up
               their own organizations. At the national level, networks of
               persons living with HIV/AIDS have been established in many
               countries. Such networks also exist at regional and global
               levels. As well, persons living with HIV/AIDS have participated
               in ever increasing numbers in international conferences,
               thanks to scholarship programs and other special funding
               mechanisms that other organizations are providing.


10.0   AREAS OF POSSIBLE COLLABORATION BETWEEN FBOs AND
       VARIOUS FUNDING AGENCIES

       FBO and the funding partners should work as partners in the
       execution of all activities including HIV/AIDS. FBOs should not be
       parasitic but work in such a manner of mutual trust with the funding
       agencies for the benefit of those disadvantaged.

       As the adage says, ‘ Do not walk behind me for I will not
       see you, do not walk in front of me for I will not follow you,
       but let us walk side by side’ –
       thus funding partners and the FBOs have to look at each other as
       equal partners working to achieve a common goal. Some of the areas
       the two could work together include:


              Join hands in breaking the silence that still surrounds the
               epidemic and removing all forms of discrimination.
              Financial/technical assistance to support the implementation
               of identified programmes.
              Networking to ensure both FBOs and the donor agencies are
               linked to important areas for the benefit of both parties.
              Information sharing to ensure transparency, avoid duplication
               of activities and for successful implementation of activities.
              Capacity Building of the FBOs to ensure sustainability of
               programmes.
              Development of skills in the design and implementation of
               programs, including means for mobilizing and accounting for
               resources.
              Advocacy and lobbying particularly focusing at policies that
               will make us ‘as partners’ achieve our objectives.




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            Promoting establishment of HIV/AIDS testing facilities and
             encouraging youth and adults to test.
            Mainstreaming HIV/AIDS, Gender, Human rights into all
             development programs while at same time creating more
             effective mechanisms for mobilizing essential resources.
            Engaging in on-going collaboration and consultation with
             other stakeholders such as Government, and recognizing the
             good efforts that each is making in the fight against the
             epidemic.
            Revising some of the theological positions which seem to
             curtail effectiveness for example on matters of sex and
             sexuality, gender, PLWAs and understanding the HIV/AIDS
             epidemic
            Facilitate availability and provision of free ARVs to the
             majority who cannot afford so that productive life of the
             infected and affected is prolonged.

11.0   CONCLUSION

The review shows that a variety of HIV/AIDS activities take place in the
FBOs at the grass root level, especially in the area of care and support.
But there is a general lack of consistent strategies, of consistent training,
of a human rights approach and gender mainstreaming of activities.

Lack of funds is listed as the main constraint and does also lead to
inconsistency in capacity building.

In all answers we see a will by FBO to do and assist more if funds were
available. It is obvious that the attitude towards infected and affected changes
and is constantly changing, but especially church leaders in HIV/AIDS should be
trained.

The FBOs ask to no longer be looked upon as a group of narrow minders,
condemning people but as important partners for Government of Malawi in
the fight against HIV/AIDS.

One could say that there are two milestones that all the FBOs set as the
most important;

      Availability of funds
      Consistent capacity building

With these in place, the work against HIV/AIDS would be immensely
strengthened.




                                       15
Key Recommendations and Milestone for the Next Two Years

              There is need to strengthen the position and role of the
               State Faith Community Task Force as a coordinating
               structure for FBO HIV/AIDS activities.
              Intensify advocacy aimed at encouraging FBOs to fully
               maximize their comparative advantage in the fight against
               HIV/AIDS without compromising approaches by other
               partners (e.g. issues related to condoms and reproductive
               health practices).
              There is need to re-prioritize mobilization to support
               HIV/AIDS activities by faith based organizations.
              There is need to facilitate human resource and technical
               support for faith based organizations (i.e. project planning
               and management and ensure that they equally benefit from
               the various funding initiatives such as the Global fund on
               AIDS, TB and malaria.




                                    16

				
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