Traditional Leaders in South Africa Encourage Healthy Behavior in Youth: An HIV/AIDS Prevention Campaign

South Africa is home to the largest number of HIV-positive people in the world. Approximately 3.5 million new HIV infections occurred in sub-Saharan Africa in 2002, with youth and women most infected. To protect their community’s younger generation from the scourge of AIDS and help prevent new infections, some village leaders in South Africa’s impoverished Eastern Cape Province are promoting abstinence.

With support from the U.S. Agency for International Development (USAID), Management Sciences for Health’s EQUITY Project, a partnership with the South African Department of Health, is implementing a comprehensive approach to battling HIV/AIDS which includes promoting abstinence. Meanwhile, the public health system offers more and more South Africans a steady supply of condoms and access to counseling and testing services.

In the Eastern Cape Province, traditional leaders have launched a 20-member team to lead HIV prevention efforts and provide assistance to people affected by the epidemic, while a national Council of Traditional Leaders works with schools to allow community elders to teach children about sexuality.

One of these leaders is Chief Mavana Dlamini, who started a successful HIV-education campaign among youth in several Eastern Cape villages devastated by the epidemic. Lacking access to medicines or health care to combat HIV/AIDS, Chief Dlamini began promoting abstinence until marriage. His willingness to speak openly about sensitive issues such as sexual behavior, HIV/AIDS, and teenage pregnancy issues have made him a dynamic leader and mentor in his community.

[The village's men arrive bearing shields and wooden fighting sticks, singing victory chants to express pride in the day's activities. Photo by Carmen Urdaneta.]The village's men arrive bearing shields and wooden fighting sticks, singing victory chants to express pride in the day's activities. Photo by Carmen Urdaneta.

Every six months, he travels through local villages to talk to adolescents, telling the boys to “zip up their pants” and encouraging young women to resist peer pressure to have sex. He also advises young couples to access local voluntary HIV counseling and testing services. For young people who admit they engage in sex, he advocates the use of condoms.

To supplement voices like Chief Dlamini’s, the EQUITY Project also supported social marketing campaigns, which included youth peer education, condom promotion, and radio call-in programs. Condom availability continues to be a concern in remote areas of South Africa, but thanks to systems improvements led by the Eastern Cape’s health providers and EQUITY, condom availability in the region’s public clinics jumped from 29 percent in 1997 to 80 percent in 2002.

Expansion of voluntary counseling and testing (VCT) services is another key marker of the EQUITY Project. Access to these counselling services in the Eastern Cape grew more than four-fold from early 2002 to mid-2003, with 300 sites now operational province-wide.

Having strong local leaders at the helm of HIV/AIDS prevention efforts in the Eastern Cape has motivated thousands of people to make informed decisions about their behavior. While abstinence is only one part of the HIV/AIDS prevention effort in sub-Saharan Africa, in Chief Dlamini's communities, young women feel a sense of pride and a renewed sense of hope. Whether they abstain, access and use condoms, or decide to get tested for HIV, in these communities, young people now have the information they need to make choices for a healthier --and hopefully HIV/AIDS-free future.

“We are helping our own people, who are suffering. The [EQUITY] Project has made our life easier, and we can now concentrate on our job to teach our community to fight HIV.” – Beauty Kanta, Nurse, Eastern Cape, South Africa