GOVERNMENT OFFICIALS
Theme 4: The need for institutional based support systems
Two key recommendations were made by the participants with regard to enhancing the implementation of the life-skills, HIV/AIDS education programme.
The main recommendation was the need for institutional based support systems, which would improve the overall co-ordination of the NIP programme.
One such recommendation is referred to in the NIP document (Departments of Education, Health and Social Development 2000) as the need for "district based support structures'. The national co-ordinator described this care and support programme as:
not so much about lay counselling but it is about linking up and establishing schools-based activities that would enhance support for the infected and the affected learner.
This approach entails the mobilisation of community resources in order to address the epidemic at a mezzo (school and community) level. The urgent need is to develop comprehensive intervention strategies to ensure that the rights of learners who are affected and infected with HIV/AIDS are protected.
Unless the institutional capacity in the school is strengthened to deal with and cope with the devastation of HIV/AIDS, the problems of learners will be treated in a vacuum. HIV/AIDS is placing an unmanageable strain on learners, educators and parents in schools and unless the present institutional capacity is strengthened by the Department of Education, then the life-skills education programme targeted at youth within the formal education sector will be ineffective.
In his writing about social workers' contribution to development, McKendrick (2001:108) cogently commented on: "their well-developed skills in developmental group work, their community work expertise, their proven ability to advocate, their programme design and evaluation skills, their strength-based perspective, their traditional emphasis on the empowerment of others, their notable capacity to not only work in teams but to facilitate the effective teamwork that intersectoral activity requires" would be vital to the school environment. Malaka (2003) adds that since all social problems are multifaceted, it is clear that social workers cannot on their own respond holistically to the needs of learners either infected and or affected by HIV/AIDS.
They have to work in collaboration with other professionals within multidisciplinary teams. Such a multidisciplinary approach would involve medical personnel, social workers and educators working in collaboration with
each other to mobilise their efforts to create an enabling environment in which not only risk reduction among learners can occur but the effects of the maturation of the epidemic can be dealt with at the school, household and community level. Sewpaul (1992) in her writing on primary care recommends that professionals transcend the duality between health and welfare, as well as education and adopt a multidisciplinary approach to practice. In the preliminary study the researchers' generic social work knowledge and skills, combined with their specialist knowledge of HIV/AIDS, small group facilitation skills, and their emphasis on working with, rather than for people were central to ensuring the success of a multidisciplinary approach to HIV/AIDS intervention programmes in the school context (Sewpaul and Raniga 2005). Chapter Eight of this thesis provides further detail on strategies to enhance a multidisciplinary approach to health promoting behaviour among secondary learners in schools in the eThekwini region.
The national co-ordinator acknowledged that this component of the Department of Education's life-skills, HIV/AIDS programme had been neglected. She stated:
The main reason that district based care and support training could not materialise was linked to the institutional arrangements of the programme and structural factors such as the relationship between central and provincial governments. The lack of human resources as well as the institutional location of the programme have impacted on the district based care and support that needed to be put in place in the sustainabi/ity of the life-skills, HIVIAIOS education programme.
Two mechanisms to operationalise the much- needed district based support structures at the schools or community level is the establishment of Health Advisory Committees as recommended by the National HIV/AIDS School Policy (Department of Education 1999) and the inclusion of social workers in schools.
These two recommendations will be discussed in detail in Chapter Eight of this thesis.
Conclusion
This chapter documented the views of district co-ordinators from KwaZulu-Natal and the national co-ordinator of the NIP programme. The discussion provided insight into the institutional dynamics of the NIP programme in KwaZulu-Natal.
There were four broad themes that were addressed namely, the relationship between central and provincial government, institutional challenges, the training of educators and the need for institutional based support systems. The discussion highlights that these broad themes are intertwined and that due to various factors such as the 'blurred' relationship between national and provincial government, the institutional challenges, training of educators and lack of district based support systems to monitor and implement the life-skills, HIV/AIDS programme, the sustainability of the NIP project in secondary schools has been limited.
The findings from this phase of the study confirmed that there is a lack of institutional capacity at school level to deal adequately with the problem of HIV/AIDS. The findings also reveal that there is a disparity in the implementation of the programme across schools in the eThekwini region (rural versus urban schools). This is as a result of the lack of resources and institutional capacity in rural schools in dealing with the problem of HIV/AIDS. A core aspect of sustaining programmes is, amongst others, the continued availability of funds and continued effective partnerships with relevant stakeholders within and outside government and within the target communities within which the school is based. There is a need to improve access to basic services (such as running water, the provision of first aid kits, training material, human resources and classroom sizes) in rural schools to deal with the problem of HIV/AIDS.
Campbell (2003) contended that broader societal and environmental factors influence the quality of sexuality programmes implemented in schools.
Additionally, the findings confirm the argument put forth by writers in the field of policy analysis such as Levin (1997), Jansson (1999); Ramanathan (1999) De Beer and Swanepoel (2002) who maintain that a disparity exists between policy goals and the resources and mechanisms that are required to operationalise policy. It was thus argued in several chapters that both the National HIV/AIDS School Policy and the National Integrated Plan document fail to take cognisance of the broader socio-structural macro factors that impact on the institutional capacity within schools to deal with the problem of HIV/AIDS
Two recommendations were made by the participants to put institutional support systems in place. The need to establish the HAC as a key district support mechanism and the inclusion of social workers within the school context. They believed that these would serve to enhance the implementation of the NIP project in the KZN region and provide holistic support and assistance both to learners and educators that are either affected and/or infected with the virus.
These recommendations are addressed in detail in Chapter Eight of this thesis.
The Chapter that follows presents the findings from the workshops held with Grade Nine learners and parents from three target schools.