The government of KwaZulu-Natal is seriously concerned with the ever increasing numbers of HIV infected people in KwaZulu-Natal. It is the government’s belief that a change in the number of HIV prevalence in KwaZulu-Natal will change the picture of HIV in the whole country.
It is also the belief of government that we need to adopt every proven intervention that will help us to change the face of HIV in the province. Critical and most important is the need for concerted effort from all stakeholders.
Together with the call of His Majesty, King Goodwill Zwelithini, the President of the Republic, Mr Jacob Zuma has also made pronouncements in efforts to reduce the scourge of the pandemic in the country. His pronouncements are to a greater extent around improving treatment access, addressing opportunistic infections and behaviour change interventions.
The President has correctly indicated the impact of opportunistic infections in the progression of HIV to AIDS. He also spoke of behaviour change interventions, Know Your Status and this programme can be seen as part of our behaviour change interventions.
In response to the call by his majesty and the President, our government is starting this consultation process with our traditional leaders, in particular, in recognition of their comparative advantage in dealing with socio-cultural norms and values that underlie sexual and related behaviours. If significant behaviour change is needed, the active support of traditional leaders is important to address issues of norms and values.
Government could not proceed without ensuring that amakhosi are part and parcel of the whole programme. Working with a broad range of traditional leadership structures, we will seek to drive behaviour change at three different levels:
* Community: social norms and contexts
* Individual: knowledge, behaviours and attitudes
* Structural factors: leadership, policy, infrastructure.
We also have a model to learn from our neighbours in Swaziland are already piloting the scale-up of this practice. In Israel, “Operation Abraham” is a collaborative medical and public health institutions working towards effective transfer of skills in male circumcision for HIV prevention through a comprehensive model of training, simulation and education. The experience gained in Israel in large scale adult male circumcision is unique and we can learn a lot from them.
Adverse events in the implementation of this programme were below two percent and in most cases very minimal. Introducing male circumcision as part of comprehensive HIV prevention requires a strategic approach which is sensitive to culture, religion, economic level and characteristics of medical services utilisation of these populations among other factors.
In KwaZulu-Natal we are considering “bush camps” where these will not only be at the medical facilities but largely incorporate health education. However, consultation is still on-going on this matter. Traditional leaders will be part of leading stakeholders of such a programme and must have the elements of personal growth and maturity. It must not be seen as being a rural community targeting programme but will seek to target all young adults, parents and uncircumcised males.
We must admit that our health care workers are already overworked and we will be urging them to support the scale-up of this programme. We would also be asking pregnant mothers to consider circumcising newborns before they are discharged from hospitals. We note the contributions by the traditional leaders and we will be taking their inputs as we develop our implementation plans and future consultation meetings. We are grateful for their support and we will announce, in due course, when we have consulted all stakeholders and ready for action.
Enquiries:
Ndabe Sibiya
Cell: 082 375 4742
Chris Maxon
Cell: 083 285 0567
Lennox Mabaso
Cell: 083 363 3097
Issued by: Department of Health, KwaZulu-Natal Provincial Government
19 January 2010
Source: Department of Health, KwaZulu-Natal Provincial Government (http://www.kznhealth.gov.za/)
