Examining the Role of NGOs in Community Water and Sanitation Improvement

This chapter examined the role of NGOs in water and sanitation improvement and the effects on the residence of Tunayilli in the Sagnarigu District. The design was descriptive. Questionnaires and interview guides were administered to household heads and key informants. Findings revealed that the water and sanitation condition in Tunayilli is generally poor. NGOs play diverse roles including the provision of water and sanitation facilities, community mobilization, and facility maintenance to ensure their sustained usability. However, inadequate funding, weak community mobilization, poor maintenance culture, and low education are challenges to water and sanitation improvement programmes of NGOs in the community. Measures to mitigate these includes increased central government funding, public education, community involvement, enforcement of sanitation by-laws, and regular maintenance of water and sanitation systems in the community. Stakeholders should intensify and sustain their educational campaigns. Meanwhile, by-laws on water and sanitation should be enforced and offenders prosecuted.

Shifting gender norms to improve HIV service uptake: Qualitative findings from a large-scale community mobilization intervention in rural South Africa

Background Interventions to improve HIV service uptake are increasingly addressing inequitable and restrictive gender norms. Yet comparatively little is known about which gender norms are most salient for HIV testing and treatment and how changing these specific norms translates into HIV service uptake. To explore these questions, we implemented a qualitative study during a community mobilization trial targeting social barriers to HIV service uptake in South Africa. Methods We conducted 55 in-depth interviews in 2018, during the final months of a three-year intervention in rural Mpumalanga province. Participants included 25 intervention community members (48% women) and 30 intervention staff/community-opinion-leaders (70% women). Data were analyzed using an inductive-deductive approach. Results We identified three avenues for gender norms change which, when coupled with other strategies, were described to support HIV service uptake: (1) Challenging norms around male toughness/avoidance of help-seeking, combined with information on the health and preventive benefits of early antiretroviral therapy (ART), eased men’s fears of a positive diagnosis and facilitated HIV service uptake. (2) Challenging norms about men’s expected control over women, combined with communication and conflict resolution skill-building, encouraged couple support around HIV service uptake. (3) Challenging norms around women being solely responsible for the family’s health, combined with information about sero-discordance and why both members of the couple should be tested, encouraged men to test for HIV rather than relying on their partner’s results. Facility-level barriers such as long wait times continued to prevent some men from accessing care. Conclusions Despite continued facility-level barriers, we found that promoting critical reflection around several specific gender norms, coupled with information (e.g., benefits of ART) and skill-building (e.g., communication), were perceived to support men’s and women’s engagement in HIV services. There is a need to identify and tailor programming around specific gender norms that hinder HIV service uptake.

Entangled Histories: Gender and the Community Mobilisations of the Ezhavas in Colonial Kerala

This paper explores how transnational historical approaches towards gender can provide a fresh perspective to locate women’s histories of colonial India and how such enquiries can widen the scope of exploring the rich archival sources available. By bringing in the recent scholarship in the area of gender and transnatioanal history, this paper would demonstrate the possibilities to unearth complex and entangled histories of women by bringing to the discussion the community consolidation efforts of Ezhavas, an erstwhile untouchable caste in the colonial Kerala, in the late nineteenth and early twentieth centuries. Focusing on the transnational character of the cultural and ideological transactions that shaped the Ezhava community mobilization in the wake of colonial transformations in the region, the paper would trace the specific ways in which such exchanges shaped the history of gender within the Ezhava movement. In doing so, this paper would point towards the need to go beyond both colonial and nationalist paradigms to unpack the intricate histories of gender, caste and regional social movements during the age of empire.

Trolls and Hacktivists

Online communities have long been the sites of political mobilization. Work on these communities in relation to politics sits at the intersection of the study of social movements broadly as well as hacktivism specifically; anthropological and cultural studies of online culture, including trolling; and work focused on the affordances of social platforms. Drawing on four linked cases of online community mobilization—4chan and trolling culture, Anonymous, Gamergate, and the 2016 US presidential election—the author discusses this varied theory and its ability to contribute to the understanding of online communities as a political and social phenomenon. The author illustrates that there are distinct repertoires of contention that emerged from 4chan prior to 2008 that subsequent movements refined and adapted. The author argues that 4chan’s affordances created a cultural identity that was durable, with shared discourse, affirmation of group values, and a history of collective action that served as a base for mobilization. These modes of collective action, including organized harassment, have since been adopted by a range of political actors. Future research should address questions of movement durability, emergence, and the interplay between internet affordances and offline contexts.

Examining Mediators of the Relationship Between Community Mobilization and HIV Incidence Among Young South African Women Participating in the HPTN 068 Study Cohort

We previously demonstrated that village community mobilization (CM) was associated with reduced HIV incidence among adolescent girls and young women (AGYW) in South Africa. Little remains known about the mechanisms linking CM to HIV incidence. Using longitudinal data from 2292 AGYW in the HPTN 068 cohort (2011–2017), we examined whether school attendance, pro-social engagement, and hope for the future mediated the relationship between CM and HIV incidence. CM was measured at the village-level via two population-based surveys (2012 and 2014). Mediators and incident HIV infection were measured through HPTN 068 surveys and HIV testing. Mediation analyses were conducted using Mplus 8.5, adjusting for village-level clustering and covariates. Hope for the future mediated the relationship between CM and HIV incidence (indirect effect-RR 0.98, bias-corrected 95% CI 0.96, 0.99). Pro-social engagement and school attendance did not demonstrate indirect effects. CM reduces AGYW’s HIV acquisition risk, in part, by engendering hope.

Exploring change over time in community mobilization domains: results from a maternity waiting home intervention in rural Zambia

Background Community mobilization (CM) is recommended as a best practice intervention for low resource settings to reduce maternal mortality. Measurement of process outcomes are lacking and little is known about how CM impacts individuals or how community members perceive its function. Given the complex and recursive nature of CM interventions, research that describes the CM process at multiple levels is needed. This study examines change in CM domains at baseline and endline in rural Zambia. Methods This secondary analysis uses data from a large maternity waiting homes intervention in rural Zambia that employed CM over 3 years as part of a package of interventions. A 19-item CM survey was collected from three groups (women with babies < 1, health workers, community members; n = 1202) with focus groups (n = 76) at two timepoints from ten intervention and ten comparison sites. Factor analysis refined factors used to assess temporal change through multivariable regression. Independent covariates included time (baseline vs endline), intervention vs comparison site, group (women with babies, healthworkers, community members), and demographic variables. Interaction effects were checked for time and group for each factor. Results Final analyses included 1202 individuals from two districts in Zambia. Factor analysis maintained domains of governance, collective efficacy, self-efficacy, and power in relationships. CM domains of self-efficacy, power in relationships, and governance showed significant change over time in multivariable models. All increases in the self-efficacy factor were isolated within intervention communities (b = 0.34, p < 0.001) at endline. Between groups comparison showed the women with babies groups consistently had lower factor scores than the healthworkers or community member groups. Conclusions Community mobilization interventions increase participation in communities to address health as a human right as called for in the 1978 Alma Ata Declaration. Grounded in empowerment, CM addresses socially prescribed power imbalances and health equity through a capacity building approach. These data reflect CM interventions function and have impact in different ways for different groups within the same community. Engaging directly with marginalized groups, using the community action cycle, and simultaneous quality improvement at the facility level may increase benefit for all groups, yet requires further testing in rural Zambia.