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Towards a "fourth generation" of approaches to HIV/AIDS management: creating contexts for effective community mobilisation

Campbell, Catherine and Cornish, Flora ORCID: 0000-0002-3404-9385 (2010) Towards a "fourth generation" of approaches to HIV/AIDS management: creating contexts for effective community mobilisation. AIDS Care, 22 (s.2). pp. 1569-1579. ISSN 0954-0121

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Identification Number: 10.1080/09540121.2010.525812

Abstract

Many biomedical and behavioural HIV/AIDS programmes aimed at prevention, care and treatment have disappointing outcomes because of a lack of effective community mobilisation. But community mobilisation is notoriously difficult to bring about. We present a conceptual framework that maps out those dimensions of social context that are likely to support or undermine community mobilisation efforts, proposing that attention should be given to three dimensions of social context: the material, symbolic and relational. This paper has four parts. We begin by outlining why community mobilisation is regarded as a core dimension of effective HIV/AIDS management: it increases the reach and sustainability of programmes; it is a vital component of the wider task shifting agenda given the scarcity of health professionals in many HIV/AIDS-vulnerable contexts. Most importantly it facilitates those social psychological processes that we argue are vital preconditions for effective prevention, care and treatment. Secondly we map out three generations of approaches to behaviour change within the HIV/AIDS field: HIV-awareness, peer education and community mobilisation. We critically evaluate each approach's underlying assumptions about the drivers of behaviour change, to frame our understandings of the pathways between mobilisation and health, drawing on the concepts of social capital, dialogue and empowerment. Thirdly we refer to two well-documented case studies of community mobilisation in India and South Africa to illustrate our claim that community mobilisation is unlikely to succeed in the absence of supportive material, symbolic and relational contexts. Fourthly we provide a brief overview of how the papers in this special issue help us flesh out our conceptualisation of the health enabling social environment. We conclude by arguing for the urgent need for a 'fourth generation' of approaches in the theory and practice of HIV/AIDS management, one which pays far greater attention to the wider contextual influences on programme success. The full text is available on open access via the publishers website.

Item Type: Article
Additional Information: © 2010 Taylor & Francis
Divisions: LSE Health
Psychological and Behavioural Science
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 16 Feb 2011 11:01
Last Modified: 05 Jan 2024 17:48
URI: http://eprints.lse.ac.uk/id/eprint/32179

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