As in other southern African countries, Human Immunodeficiency Virus (HIV) and the
Acquired Immunodeficiency Syndrome (AIDS) are taking their toll in Namibia. At a
national level, the Ministry of Health and Social Services (MOHSS 2005) sentinel survey
showed that about 19.7% of the population is infected with the virus that causes AIDS.
HIV prevalence in the country was determined to be 17.8% by the 2008 Sentinel Survey.
According to the 2008 Sentinel Survey (MOHSS, 2008) the highest age-specific
prevalence rate in Namibia is among those aged 30-34 year.
According to the recent UNDP 2009 report, Namibia, together with Botswana, South
Africa and Swaziland have achieved more than 80% of the target on Preventing MotherTo-Child
Transmission of HIV (PMTCT+). According to the UN, significant proportions of
Namibians, particularly rural women and isolated groups, do not have complete and
accurate information about HIV/AIDS prevention or treatment strategies. Many
Namibians do not want to get tested for HIV due to stigma and discrimination. The rollout
of ARV treatment and PMTCT+ can mitigate the stigma, but access is still limited
and understanding of treatment is low. Additionally, where the ARV treatment and
PMTCT+ were decentralized, seasonal factors such as floods also negatively affect the
efficiency of follow-up, adherence, care and treatment regimes.
Furthermore, Namibia also provides social protection and benefits for the elderly, and
those with disability (World Bank (2010). Namibia has a relatively stable economy, with
minerals dominating the economy. In spite of all advances in the country, more than one
in four Namibian families lives in poverty. Namibia has one of the highest degrees of
income inequality in the world with a gini-coefficient of 0.7071
.
As a key step in scaling-up a more effective, relevant and sustained primary health care
and community-based HIV/AIDS treatment, care and prevention response in high
prevalence resource-poor settings, ten institutions in six different countries in Africa
(Zimbabwe, Namibia, Botswana, Tanzania, Malawi, and Mozambique) together with
partners in Italy, England and Finland, decided to undertake a research to understand
and compare community-based HIV/AIDS approaches with the ultimate aim to define
best community-based HIV/AIDS service delivery practices in Africa. One of the study’s
rationales is to understand community-based treatment and care efforts from the point of
view of the beneficiaries.
The study used mainly qualitative Participatory Reflection and Action (PRA) approaches.
PRA is often associated with weaknesses of time-consumption and it is not
recommended to use the approach without a follow-up commitment to take action on the
problems identified. However, PRA research provides a powerful means of improving
and enhancing practice by involving community dialogue at the very early stages of
programme planning. Thus, it builds a basis for negotiation and partnership between
researchers, resource holders and beneficiaries.