Nonzuzo Mbokazi (Research Administrator, UCT)
Editorial Note: In this piece, Research Administrator for the iALARM Project, Nonzuzo Mbokazi, shares reflections from the Gugulethu UCT Research Indaba and provides an overview of the strides made by iALARM to raise the Alarm about HIV/AIDS among men and boys.
Nelson Mandela once said, “Health cannot be a question of income; it is a fundamental human right”. On this year’s Mandela Day, 18 July 2019, iALARM, a research and community engagement project based at the UCT School of Public Health and Family Medicine’s Division of Social and Behavioural Sciences, invited members of NGOs, CBOs, local health facilities, and the Gugulethu community to participate in sharing the spirit of ubuntu (togetherness) at the Second Annual Gugulethu-DSBS, UCT Research Indaba.
The Indaba was a space to learn about and discuss new research on important public health issues in the Cape Town community of Gugulethu. The idea was to share knowledge and promote the ongoing collaboration between the iALARM project, community members and the local health system. Throughout, we tried to steer away from the conventional top-down approach to research dissemination. While dissemination of health research is critical if it is to be of any use in shaping knowledge, attitudes and practices, it is often not done well, or even done at all. Many people at the Indaba in fact said they had seen nothing like this in their community, evidence of ineffective engagement by researchers. Attendees said they gained valuable information and commented on the engaged discussions the space was able to provide as well key takeaway messages.
iALARM stands for “Using Information to Align Services and Link and Retain Men in the HIV Cascade”. It is an ongoing effort in the Division to raise awareness around and conduct research to better understand the health needs of men and boys, with a focus on HIV. At the Indaba, we heard from Lesley Gittings on some of her PhD thesis findings, HIV-positive adolescent boys’ engagement with HIV treatment and care during and following ulwaluko (traditional initiation/circumcision) in the Eastern Cape Province of South Africa. She spoke about the ways that HIV-positive adolescent boys and young men (ages 13-22) take care of their health during and after ulwaluko in the Eastern Cape, and her presentation sparked a great discussion. A key lesson from this presentation according to participants at a meeting was that while mothers do not want to know the details of the initiation school, they definitely do want to be part of the process leading up to the boys going ‘to the mountain’ and when the boys come back. They said that education on how to support their children when they return is necessary. They wanted to be active in taking them to the clinic and providing them with the necessary attention in terms of their health. This is an example of how the Indaba facilitated fruitful discussion and imparted knowledge and elicited useful suggestions. It speaks to the impact of sharing knowledge and how research findings can be used to inform a larger dialogue in the health system about community needs.
Yandisa Sikweyiya, Associate Professor at the School of Public Health, University of Witswatersrand and Specialist Scientist at the SAMRC spoke about research to expand an existing HIV adjustment and coping intervention called Sondela and tailor it to better help men to link and be retained in care. This research is being done in collaboration with other researchers from the SAMRC and Brown University. Sondela [an isiXhosa verb meaning `come near'] seeks to increase psychological wellbeing and resilience; build gender equitable relationships; reduce HIV risk behaviour; increase health-seeking behaviour and build social support networks. The Sondela intervention was of much interest to community members at the Indaba. They were keen to learn more about it and wanted to find out how they could get more information on how it might be rolled out in Gugulethu.
Most of iALARM’s research focuses on men and HIV, but the Indaba also included presentations and discussions focused on broader health issues in the area. The Indaba tried to serve as a platform for the dissemination of health research and information to the wider community and health systems in and around Gugulethu.
Other topics covered at the Indaba included research focused on:
Male community activists in Gugulethu
New forms of fatherhood and fathering
The use of social media to manage romantic relationships
Experiences of HIV research study participants in Gugulethu
Current efforts in Southern and Eastern Africa to engage men in HIV services
Using information to strengthen relationships between communities and health systems
Pregnant women and medicine use in Gugulethu
iALARM is grateful to share a strong relationship with the community of Gugulethu. The event was planned in partnership with the Movement for Change and Social Justice (MCSJ) which is a new social movement founded in Gugulethu. MCSJ emerged in parallel with the work of iALARM and although its objectives have grown beyond iALARM’s focus on men and HIV, this movement brings to the forefront socio-economic issues facing the community of Gugulethu, such as the barriers to adequate healthcare services and women’s issues such as sexual and reproductive health and gender-based violence. MCSJ’s partnership with iALARM continues to grow from strength to strength.
Sonke Gender Justice, a non-profit organisation working throughout Africa (with offices in Gugulethu) with women and men, girls and boys to resist patriarchy, advocate for gender justice and achieve gender transformation, is also a key partner with iALARM. Sonke appreciates the need to be active in engaging men in HIV services because men and boys are underrepresented in HIV services while being overrepresented amongst AIDS deaths and a key part of the cycle of new HIV infections, a cycle which needs to urgently be broken. To do this, Sonke works closely with iALARM to emphasize the focus on men and the necessity of men’s participation in HIV response efforts.
The Department of Health is also a stakeholder in the iALARM project. Mr. Msokoli Qotole, Deputy Director in the Directorate of Social Mobilisation: HIV/AIDS, STI & TB in the Western Cape, Department of Health, was a speaker at the Indaba, and he commented on how health systems acknowledge the need to render health services using different strategies for different populations. This means we need to think about how to better engage men in health programmes and ensure that they are comfortable to make use of these services.
The Research Indaba is one of the strategies used by iALARM to bring together people from inside and outside the health system, to provide a platform to share new ideas, build relationships and work towards better health for all. Other strategies we are using include the Linkage and Retention Task Team meetings, held six times a year, Task Team (TT) meetings are a space that brings together health systems, government and community actors together to engage and problem solve shared challenges. The TT meetings are designed to share different types of health information among a diverse group of health stakeholders to promote collaboration within the health system. The Networking Meeting, held once a year, is a strategy iALARM uses to bring together local organisations to consider collaborations, engage with each other, build relationships, and share their work and relevant information.
iALARM activities are enabled by a grant received from the National Institute of Mental Health (in the US) as well as support from the South African National Research Foundation.
Nonzuzo Mbokzai (UCT) is the Research Administrator for the iAlarm Project. She is currently pursuing a PhD with the Department of Sociology at the University of Cape Town, the title of her PhD thesis is “Understanding low-income working mothers and childcare state policy in rural and urban KwaZulu-Natal”. Nonzuzo has a strong interest in public policy; as she is of the view that the social sciences can help to better understand how institutional inertia affects public policy initiatives, which is pertinent to a developing country such as South Africa.
Division of Social and Behavioural Sciences
School of Public Health and Family Medicine
Level 3 Falmouth Building
University of Cape Town