Community-based HIV/AIDS research--whither community participation? Unsolved problems in a research programme in rural Uganda

Involvement of the study community in research on HIV/AIDS has presented the MRC/UVRI programme in rural Uganda with a multi-layered challenge. A typology developed in agricultural research which defines different levels of community participation in research is described where participation may be at 'contract'; 'consultative'; 'collaborative' and 'collegiate' level (each level indicating an increasing degree of community participation). Community involvement in the MRC/UVRI Programme is then outlined and the typology applied. It is shown that the majority of community participation in the Programme is at the contract level since the nature of the research programme as a 'foreign imposition' with 'foreign goals' has precluded the involvement of the community in much of the policy development and research planning. However; it is noted that as the Programme becomes more established in the area community influence grows and signs of community impact on policy and increased research inputs are beginning to be seen. The question is raised as to whether it is realistic to expect that externally imposed health research; particularly on sensitive topics; can ever be truly community participatory research

Building Community Capacity to Cope with Adversity: The Role of Traditional Support Networks

"Introduction: In parts of Uganda the Impact of the AIDS epidemic is overwelming. Traditional community support networks have; however; been weakened due to the past economic and political turmoil; aid agencies are increasingly involved in providing ""emergency aid"". Objective: To examine how best external aid can contribute to the building of a self-sustainable community developmental activities in approximately 50 villages using a community based approach. The role of the unit is limited to facilitating the developmental process by providing expertise and advice to communities on how to harness available resources for development. Methods: The MRPA community support and counseling unit was set up in 1990 and carries out health; counselling; educational and developmental activities in approximately 50 villages using a community based approach. The role of the unit is limited to facilitating the developmental processes by providing expertise and advice to communities on how to harness available resources for development. Results: In two years more than 30 village committees were established to provide support for community health work. Volunteer community health workers and birth attendants carry out community health activities. The number of active women's groups in the area increased from nil to 13. Particularly interesting is the recent self initiated revival of a ""Munno Mu Kabi"" group (litterary: yours in need); by a group of women from 7 villages. Members meet forthnightly to discuss the problems on needy familities in their villages; in particular those with AIDS patients. These families are visted and advice is given as well as material assistance. To date the group has helped 56 families. Conclusion: Our experience indicates that external support can result in community initiatives which are suggestive for the existance of a community developmental capacity; it is rather early; however; to know if this capacity is sustainable . The revival of a traditional system suggests the external agencies aiming at community capacity development should explore the use of traditional support structures."