SWOT ANALYSIS OF HIV/AIDSACTORS

NATIONAL SYNTHESIS FORUMPresented by:Mr. Ntegyerize FulgensioDRI FACILITATOR - KABAROLE

Introduction

Uganda’s response takes a multi-sectoralapproach involving various actors in directand indirect activitiesThis presentation considers services,initiation of programs, service deliverystructures, capacities, linkages, resourcesand coordination

HIV/AIDS Service Providers

Broad categories of actors include:Central and Local GovernmentInternational Development PartnersIndigenous NGOsFaith Based OrganizationsCommunity Based OrganizationsCultural and Traditional InstitutionsThe mediaThe private sector

Central Government

Taking a lead role in HIV/AIDS. Involved in:Provision of a policy & strategic frameworkConceiving programs & intervention modelsCoordination & supervision of HIV/AIDSactivitiesResource mobilization for HIV/AIDSCapacity building and researchProvision of HIV/AIDS services tocommunities thru local governments

Local Government

Engaged in planning for general development, forthe health sectors & HIV/AIDSProvide treatment services through the structure ofhealth units at different levelsSupervise, monitor and evaluate the HIV/AIDSsituation in the districtsCoordination of HIV/AIDS responses in the districts.A few are engaged in research activities

International Development Partners

Conceptualization of the HIV/AIDS problemsand behavioral factors & help communities toplan intervention activities.Fund HIV/AIDS services and HIV/AIDSrelated researchCapacity buildingProvide services to the communities directlyor through local governments and CSOs

Indigenous NGOs

Mostly engaged in prevention, care & support toPHAs & their families, and capacity buildingVCTAwareness creation on HIV/AIDS -have trainedcommunity-based counselors & drama groupsCondom promotion and distributionSupport to orphans, widows and PHAsFacilitate access to credit for PHAs to mitigateimpacts of the epidemicOrganizational development services

Community Based Organizations(CBOs)

Formed by community to respond to communitysocial problemsUsed by NGOs to mobilize communities forHIV/AIDS workUse drama, music, seminars and assemblies tocreate awareness on HIV/AIDSCondom social marketing, peer-to-peer educationand guidance, condom distribution, promotion ofparents’ adolescent dialogue on sex

CBOs (Cont’d)

Skills development for production anddevelopmentCBOs manage Income Generating Projectsfor PHAs and their affected families

Faith Based Organizations (FBOs)

Prevention and control by disseminating informationPromotion of behavior changePromotion of faithfulness and abstinence.A few FBOs have started promoting condom use afterseeing many believers dying prematurelySpiritual and psychosocial counseling for PHAs andtheir families,Home based care and home visitingProvision of material support to PHAsTreatment in the health units owned by the differentdenominations.Traditionalists treat some of the opportunisticinfections such as diarrhea, herpes zoster and fevers

The Media and the Private Sector

The media especially the FM radio stationsplaying a big role in HIV/AIDSThe print media has also made a contributionthrough Straight Talk - a monthly newspaperdesigned to help adolescent youth to avoidHIV infection through open discussion ofsexual matters and personal health

Cultural and Traditional Institutions

Cultural leaders pass on HIV/AIDS messages totheir subjects. In Moroto the district sensitizes kraalleaders about HIV/AIDS who then pass the messageto the migrant pastoralists.Traditional healers provide treatment services forHIV/AIDS.Toro kingdom on the other hand is actively involvedin the fight against HIV/AIDS through AYA programs.

SWOT ANALYSIS

The SWOT analysis was intended identifyexisting competencies and gaps as well asdrawing lessons for future scaling up

SWOT-Central & local Government

STRENGTHSStrong human resource baseImplementation structure downto grassrootsResource mobilizationHas a think tank to formulatepolicies, and interventionsRelatively stronger financialbaseAccess drugs for STDs and OIsBroad coverageWell established infrastructureGood working relations withNGOs and other partnersHave coordination mechanisms

WEAKNESSESLack adequate fundsLimited monitoring of NGOsGaps in coordinationInsufficient drug supplies inhealth unitsFew orphan programs beyondUPEHealth sub districts given muchresponsibilities with meagerresourcesNot reaching remote andphysically isolated areasLimited surveillance systemLack of VCT equipment andservices in many health centres

Central & Local Govt (Cont’d)

OPPORTUNITIESFavorable donor relationsCommitment to reducingHIV prevalenceDecentralization policyenabling control anddistribution of resourcesCommunities responsive toprogramsPolitical will at district levelSupport from MoHDonor interestMulti-sectoral approach

THREATSSustainability of programs dueto reliance on external fundingPovertyIncreasing number of orphansPoor accessibilityInsurgenciesExistence of transientpopulationsAttitudes of hopelessnessamong the infected

International Development partners

STRENGTHSFunding HIV plansCompetent motivatedstaffStrong financial baseFunds allocated inaccordance communityneedsFavorable relations withcentral & local gov’tsBroad coverage ofprograms

WEAKNESSESLimited planning withlocal actorsLimited coordination withother agenciesMakes little consultationwith community whenintroducing IEC materialRestrictive budgets inview of local prioritiesLimited transparencyTop down planningapproach

International Development Partners(Cont’d)

OPPORTUNITIESFavourable workingrelationships with otheractorsCommitment toreducing HIV/AIDS

THREATSNon-sustainability ofprograms bygovernmentLimited solidifiedreputationDifferent financial yearswith local governmentLimited skilled labour atcommunity level

INDIGENOUS PARTNERS

STRENGTHSService delivery structuresat the grassrootsAble to monitor and evaluateactivitiesTarget vulnerable groupsWell trained, motivated staffStrong partnership withdistrict administration andinternational agenciesAble to achieve more withlimited resources

WEAKENESSESLimited geographicalcoverageDuplication of servicesLimited capacity to mobilizefunds locally

INDIGENOUS PARTNERS (Cont’d)

OPPORTUNITIESIncreased demand forHIV/AIDS servicesPotential for expansion throughsupportSupportive donorsLocal resourcesDecentralisation policyResponsive community

THREATSLimited fundingLong on-going insurgenciesLack of appropriate IECmaterials in vernacularPovertyOverwhelmed with demand forservicesDuplication of servicesOver reliance on donor supportHIV/AIDS and TB stigmatised

FAITH BASED ORGANISATIONS

STRENGTHSHave regular contacts withtheir followers andcommand strong respect.well established andextensive structures andinfrastructureStrong support from thecommunityConversant with HIV/AIDSproblemsHave willingness to care forPHAs and affected families

WEAKENESSESLack of skills to implementinterventions in care andsupportLimited HIV/AIDS controlprograms and tools tochange behavior

FAITH BASED ORGANISATIONS(Cont’d)

OPPORTUNITIESNear to localcommunitiesEasily identified withthe locals

THREATSConflicting values andattitudes with those ofthe control program e.g.on condom useInadequate fundingOverwhelmed bydemand for services

COMMUNITY BASED ORGANISATIONS

STRENGTHSConversant with HIV/AIDSproblems at the local levelCommunity sanctioned andinitiatedCommunity basedinnovativenessVoluntarism of thecommunityFocussedClose linkage withcommunity

WEAKNESSESInadequate capacity toimplement most interventionsQuality of messages sent outquestionable if not monitoredOver dependency on externalassistanceLack well trained personnelHave limited coverageLimited gender sensitivityLimited local response inpreventionLimited capacity to mobilisefunds locally

COMMUNITY BASED ORGANISATIONS(CONT’D)

OPPORTUNTIESStrong support from communityDecentralisation policyPolitical will

THREATSInadequate personnel tocarryout the set tasks.Limited coverageInadequate fundingLack of electricity to use videoequipmentDepend on volunteers, notsustainableWaning spirit of voluntarismOver reliance on donor supportHigh turn over of membershipHIV/AIDS TB stigmatized

Cultural and Traditional Institutions

STRENGTHSProvide personalized careWillingness to care

WEAKNESSESPoor skills in palliative andprophylactic careInability to provide fororphans

OPPORTUNITIESCommunity members have alot of trust in culturalinstitutions

THREATSLarge family sizes erodingresourcesExorbitant charges

Conclusions

Uganda’s response to the HIV/AIDS epidemic ischaracterized by different actors each making acontribution in accordance to their comparative advantage

The Central government plays a pivotal role in the fightagainst HIV/AIDS through the provision of policy,advocacy, a strategic framework, monitoring andevaluation, and resource mobilization for implementationof HIV/AIDS activities through UAC, Ministries of Health,Local Government

Conclusions-Cont’d

NGOs and CBOs have direct linkages withthe grassroots and are able to offer servicesthat require direct interaction with thecommunityInternational development partners bring tothe fore financial resources and humanresources.

Conclusions-cont’d

Many plans developed by local actors remainunimplemented or partially implemented due toinadequate funds and lack of capacity to mobilizeresources aggravated by rampant poverty and alow revenue base for districts and sub-counties.The districts’ capacity to undertake adequate M&Eto ensure appropriate implementation of strategicactivities, facilitation of future program design,strategy evolution and efficient resource allocation,needs to be scaled up

Conclusions-cont’d

Despite Central government efforts todevelop coordinating structures for HIV/AIDSactivities in the districts there is limitedmonitoring of NGO and CBO activities whichleads to duplication of effortMainstreaming is not systematicallyaddressed in the implementation of manysectoral grassroots activities

Conclusions-cont’d

Indigenous NGOs and CBOs are able to offerservices and reach many people at grassrootswith minimum resources through the use ofcommunity based volunteers.The sustenance of the spirit of voluntarism ishowever a challenge.The media particularly radios are effective increating awareness about HIV/AIDS because oftheir wider coverage and entertaining programswhich influence people to listen to them.

Conclusions-cont’d

Many agencies involved in HIV/AIDSespecially those that came into being withintroduction of STIP, do not have welldeveloped strategic and operational plans forthe programs they are implementing.Many also have no definite ambitions; theykeep shifting focus to even response areaswhere they have no expertise.