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this page Situational Analysis
Problem Statement
CAPA is affected and concerned about the impact of the epidemic of HIV/AIDS, TB and Malaria in the communities in which it serves. This includes an increase in illness and death, especially amongst young adults; an increase in the number of persons needing care including widows, orphans and vulnerable children; elderly caregivers/guardian, decrease in economic status of the people due to illness, early death and overstretching of health facilities among others.
HIV/AIDS Transmission
HIV is transmitted through sexual intercourse with an infected individual, transfusion of infected blood, mother-to-child transmission and through contaminated sharp objects with infected blood and body fluids. A large percentage of HIV infection occurs through sexual transmission, either vaginal or anal sex. Therefore, prevention in Sub - Saharan Africa (SSA) largely focuses on disrupting this mode of transmission. Reduction of the spread of HIV can be achieved by abstinence from sex before marriage and mutual heterogeneous fidelity within legal union as well as appropriate and consistence use of condoms by married couples who are HIV positive or discordant to avoid re-infection. However, this does not stop unfaithful partners from infecting faithful partners. Similarly faithful couples may carry infections from previous relationships.
To break the chain of this transmission, the sexually active population should adopt a more positive sexual behaviour in line with God’s injunction. The behaviour change approach has gradually produced results. Since behaviour modification is one of the bedrocks of Christianity, this should be intensified. The Church commits itself to playing a significant role to educate and influence the behaviour and values of her members and communities that will break the chain of sexual transmission of HIV.
Stigma, Denial and Discrimination
Stigma, denial and discrimination (SDD) has made many people not to talk openly about HIV and AIDS in Churches. In many congregations the talk on HIV/AIDS is taken with mixed feelings. While some consider it a serious taboo issue, others regard it as embarrassing. Stigma and discrimination to persons living with and affected by HIV/AIDS worsen the spread and impact of the epidemic.
Situational Analysis
Due to the fear of discrimination and stigmatization, individuals living or affected by HIV/AIDS remain silent about their HIV status. This leads to under-reporting of the spread of the epidemic and resistance to the use of VCT services. Affected people shy away from seeking treatment leading to a persistence denial that negatively affects the Church and the wider community.
Care in Health Systems
The infrastructure of the health system within CAPA is weak. Poor coordination and supervision has led to gaps in services delivery. The shortage of health care personnel to administer HIV related care and services has also affected the quality of care given to PLWHA and people affected by AIDS. Blood is still being transfused without HIV screening in some rural centres. This act increases the risk of transfusing HIV infected blood. Strategies will have to be developed to increase the availability of safe blood within blood banks and the screening practices observed within health institutions. CAPA through her Provincial and Diocesan health system has a responsibility to ensure that quality health care and services are provided within its health facilities.
Prevention of Mother to Child Transmission (PMTCT)
The transmission of HIV from mother to child contributes largely to the HIV prevalence amongst children. Efforts to reduce this mode of spread will include increasing the number of pregnant women who know their HIV status and are adhering to advice and counselling to protect their children from the possibility of infection. CAPA recognises the need to protect the rights of all people including un-born children from harm.
Socio- Cultural Beliefs, Attitude and Practices
A number of harmful socio-cultural attitudes and practices increase vulnerability of persons to HIV/AIDS. Efforts must be made to change such practices. These include polygamy, wife cleansing, wife inheritance, inhumane burial rites and other practices that deny women and girls rights to economic development and education. Cultural practices may lead directly to transmission of HIV infection. These include the use of un-sterilised sharp objects in the practice of female genital mutilation (FGM), male circumcision, abortions, deliveries, and tattooing.
Orphans and Vulnerable Person
Due to all these, the number of orphans under the age of 18 years has
increased drastically in Africa. Some of these orphans are already infected
with HIV, TB or Malaria, due to their deplorable socio – environmental
situation. A significant number of them are currently ill and dying of
these preventable and treatable infections. Majority of these orphans are
heading homes and assuming parental responsibilities over their siblings
and aged grandparents. This undermines their developmental status. The
poor socio- spiritual support by family members and discrimination by
community members further puts most of them in vulnerable positions. This
often leads to child prostitution, illiteracy, street hawking etc. Addressing
these problems will require strategic and collective efforts at all levels
of the society.
HIV/AIDS Situation in Africa
It is now 25 years since HIV/AIDS cases were first reported. Sub-Saharan Africa remains hardest-hit, and is home to 25.8 million people living with HIV, almost one million more than in 2003. Two thirds of all people living with HIV are in Sub-Saharan Africa. 77% of all women with HIV are to be found in Africa. An estimated 2.4 million people died of HIV-related illnesses in this region in 2005, while a further 3.2 million became infected with HIV. The increase in the proportion of women being affected by the epidemic continues. In 2005, 17.5 million women were living with HIV - one million more than in 2003. Thirteen and a half million of these women live in Sub-Saharan Africa.
The current situation is characterized with an overwhelming number of orphans, other vulnerable children, widows and widowers. This situation has overstretched the resources of nations, communities, families and individuals, seriously undoing the countries developmental gains.
The prevalence rate within the Anglican Provinces in Africa is 1% to 40% especially in countries of Southern Africa. For example countries within the Province of Indian Ocean have prevalence rate of 1% - 20%, while countries within West Africa Province, including Nigeria, have prevalence rates of between 2% - 5.5%. Though West Africa has been less severely affected compared to other parts of Sub-Saharan Africa, Nigeria has the highest number of people living with HIV than any other country in the world except South Africa and India. Prevalence rate within Eastern Africa countries is 2.4% to 13%. HIV prevalence rate in Kenya and Uganda have declined over the years. UNAIDS attributed the decline of HIV infection in Uganda and Kenya to behaviour change.
In Southern and East Africa, as well as parts of Central Africa, AIDS infections will most probably continue to rise for some time. The declines observed in Uganda and more recently, in Kenya and Zimbabwe confirm that the epidemic can respond to specific HIV-related interventions. However, in high prevalence settings, it is important to continue to address underlying socio-economic and socio-cultural dynamics that create situations of vulnerability to maintain the decline in infection rates.
Reduction in HIV/AIDS prevalence rate can also be partly attributable to the various programmes implemented through Church’s response to HIV/AIDS. In most Provinces, the awareness is very high. There is however concern that stigma and discrimination in most countries does not correlate with the level of HIV/AIDS awareness. What is that saying to the Church in Africa? With concerted effort, the HIV infection will be reduced drastically if the Church takes responsibility and optimally uses her nation-wide structures to address HIV/AIDS related stigma and discrimination issues, advocate for appropriate HIV/AIDS policies as well as mainstream HIV/AIDS into her core evangelical mission.
TB Situation in Africa
Tuberculosis (TB) is a contagious disease that spreads through the air.
When infected people cough, sneeze, talk or spit, they propel TB germs,
known as bacilli, into the air. A person needs only to inhale a small amount
of these to be infected. Left untreated, each person with active TB disease
will infect on average between 10 and 15 people every year. However, people
infected with TB bacilli will not necessarily become sick with the disease
because the immune system “walls off” the TB bacilli.
The TB bacilli however are protected by a thick waxy coat, which can lie
dormant for years. Thus when someone’s immune system is weak, the
chances of becoming sick are greater.
TB is a leading cause of death among people who are HIV-positive. It accounts for about 13% of AIDS deaths worldwide. In Africa:
- HIV is the single most important factor determining the increased incidence of TB and Malaria in the past 10 years.
- The number of tuberculosis cases rose by 5% from 2003 to 2004 and 70% of those infected with TB and HIV in the world are in Africa.
- Up to 80% of adult TB patients’ are HIV infected in some region while in most of Eastern and Southern Africa where combined TB and HIV prevalence rates are highest in the world, less than half of TB patients are accessing effective TB treatment.
- In many Sub-Saharan African countries the number of persons with TB has quadrupled since 1990 mainly because of HIV.
About 5,000 people die from Tuberculosis (TB) everyday around the world. Although TB can be successfully treated even if someone is HIV infected, it is among the leading killers of people living with HIV. Recent research shows that between 11% - 60% of total deaths of people living with HIV and AIDS is caused by TB. If TB is left unchecked, in the next 20 years, almost one billion people will become newly infected, 200 million people will develop the disease and 35 million will die of it around the world.
Malaria Situation in Africa
Malaria is a disease caused by the parasite Plasmodium. The parasite is spread or transmitted to people by the bite of an infected female Anopheles mosquito, which feeds on human blood at dusk and during early night hours. Some vectors have biting pecks around midnight or early hours of the morning. Human is the only important reservoir of human malaria. Plasmodium falciparum is the commonest species in most Sub-Saharan Africa countries and is associated with significant morbidity and mortality. There are other species of malaria parasite.
Malaria is one of the leading causes of child mortality. Each year, there are around 500 million new malaria infections, which cause between 0.7 to 2.7 million deaths, most of them in young children of Africa. It is estimated that children under 5 years of age account for 82% of all malaria deaths. About 3000 children die of malaria daily. Malaria is responsible for a fifth of all childhood deaths in Africa. Nearly half of all requests for treatment in clinics and hospitals in Africa are for malaria. Malaria negatively impacts many Africa communities by reducing the number of people able to work effectively. Aside from young children, pregnant and poor women and impoverished communities are more at risk and most affected by malaria parasite.
Malaria infection can be controlled by providing early accessible and affordable quality treatment and sustainable preventive measures, such as the use of Insecticide Treated Nets (ITN) and Indoor Residual Spray (IRS). These are the most effective ways of protection from malaria and reducing its spread, particularly in young children, pregnant and nursing mothers. Seeing the devastating impact of these infections on families and communities, CAPA plans to adopt innovative and sustainable ways to respond more appropriately to curtail the impact of malaria.
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