Posted July 1998
The Implications of HIV/AIDS for Rural Development Policy and Programming:
Focus on Sub-Saharan Africa
by Daphne Topouzis
Sustainable Development Department, FAO
HIV and Development Programme, UNDP
This page presents the Table of contents and Executive summary of the paper.
The full paper is also available for downloading via FTP (MS-Word 6, zipped, 74K)
Table of contents
Glossary of terms and acronyms
1. Introduction: Purpose and scope
2. The interface between the rural institutional environment and HIV
2.1 The rural dimension of HIV
2.2 Rural susceptibility and vulnerability to HIV/AIDS
2.3 Why do rural institutions need to address HIV/AIDS?
2.3.1 The inter-relationships between formal rural institutions and HIV
2.3.2 The inter-relationships between informal rural institutions and HIV
2.4 Aligning rural development policies and programmes with the response to HIV
3. Conceptual framework on the implications of HIV/AIDS for rural development policies and programmes
3.1 Key cross-cutting issues
3.2 Rural development policy and programme focus areas
3.2.1 Poverty alleviation
3.2.2 Food security and sustainable livelihoods
3.2.3 Empowerment of rural women
4. Rural development policy and programme planning for HIV/AIDS
4.1 Rural institutional strengthening/capacity building
4.1.1 Rural development sector/sub-sector susceptibility/vulnerability assessment
4.1.2 Human resource needs/capacity assessment of rural institutions
4.1.3 Participatory training for rural institutions and their clients
4.1.4 Policy and programme review
4.1.5 Mandate on HIV/AIDS
4.1.6 Management Information System on HIV/AIDS in rural areas
paper examines the implications of the HIV epidemic for rural development
policies and programmes in sub-Saharan Africa and, in particular: the inter-relationships
between rural development and HIV/AIDS; and the broad policy and programming
challenges that the epidemic poses for rural institutions. The proposed
conceptual framework for the identification of key policy and programming
issues for rural development raised by HIV is intended to provide guidance
for the design and conduct of a set of four case studies to be carried out
in Southern and Eastern Africa. The main objective of the case studies will
be to help formal and informal rural institutions generate policy and programme
responses to the HIV epidemic (in the areas of land tenure, agricultural
research, training and extension, appropriate technology, credit, etc.)
in each of the four countries.
The relationships between rural institutions and HIV/AIDS are bi-directional:
The following key points cross-cut the proposed conceptual framework on
the implications of HIV/AIDS for rural development policy and programming:
- the epidemic may have an effect on rural institutions. The effects of
HIV/AIDS on formal rural institutions may: i) impoverish directly affected
clients; ii) erode the capacity of rural institutions through losses in
human resources; and iii) disrupt the smooth operation of rural institutions
by severing key linkages in the organisational and/or production chain.
The effects of HIV/AIDS on informal rural institutions may create a crisis
of unprecedented proportions particularly among the extended family and
kinship systems, with implications not only for the spread of HIV but also
for the viability of rural institutions and of traditional social safety
mechanisms (widow inheritance, child fosterage, etc).
- the policies and programmes of rural institutions may have a positive
or negative effect on the HIV epidemic (i.e. by enhancing mobility and strengthening
urban-rural linkages, they may inadvertently facilitate HIV transmission;
by improving support and social services, they may contain the spread and
impact of the epidemic).
The proposed conceptual framework focuses on selected rural development
focus areas, and in particular on:
- The causes and consequences of the HIV epidemic are closely associated
with wider challenges to development, such as poverty, food and livelihood
insecurity, gender inequality. In effect, HIV/AIDS tends to exacerbate existing
development problems through its catalytic effects and systemic impact.
- In areas heavily affected by HIV/AIDS, the catalytic effects and systemic
impact of the epidemic on rural development may:
- amplify existing development problems to such an extent as to trigger
structural changes (i.e. in adult and infant mortality); and/or
- create new problems and challenges for rural development (child-headed
households, the breakdown of informal rural institutions and thus of certain
vital social safety net mechanisms).
- Given that many problems arising from the epidemic are not specific
to HIV/AIDS, policy and programme responses need not be HIV/AIDS-specific
but must address the root causes and consequences of the wider challenges
to rural development. In other words, a developmental rather than an AIDS-specific
focus is critical to tackling the multi-sectoral complexity of the epidemic
and its systemic impact and to ensuring the sustainability of both HIV/AIDS
responses and rural development efforts.
- The policy environment plays a key role in defining the parameters of
susceptibility/vulnerability to HIV/AIDS and of the impact of the epidemic.
- Gender, age and marital/family status play as decisive a role in determining
susceptibility/vulnerability to HIV/AIDS and the potential impact of the
epidemic as economic and cultural conditions. For this reason, the interplay
between these factors needs to be considered at each stage of policy and
- The policy and strategy recommendations put forth by the World Conference
on Agrarian Reform and Rural Development and by the World Food Summit in
particular provide a springboard from which to mainstream HIV/AIDS in rural
development policies and programmes. In particular, WCARRD's focus on poverty
alleviation and participation by rural people in the institutions that govern
their lives as a basic human right, and the World Food Summit emphasis on
food security and sustainable human development are not only prerequisites
for the revitalisation of the rural economy, but also for effective responses
- Rural development policies and programmes in support of poverty alleviation,
food and livelihood security, the empowerment of rural women, etc. are,
in effect, also HIV prevention and AIDS mitigation measures and vice versa.
- While rural development programmes can be integrated with HIV/AIDS prevention
and mitigation programmes, HIV/AIDS-specific policies and programmes have
an important complementary role to play.
This section examines the broad inter-relationships between poverty and
HIV, identifying gaps in knowledge (i.e. on household coping strategies),
critical issues that are not currently being addressed (such as the consequences
of HIV-related inter-generational poverty and of the increasing asset/land
concentration and marginalisation of the poor) and alternative targeting
criteria (such as adult death and/or household dependency ratios) for poverty
Food security and sustainable livelihoods
The dynamics of labour mobility/ migration and food security/sustainable
livelihoods are critical dimensions of HIV transmission and impact. This
section raises the issue of the sustainability of labour-intensive food
production strategies, upon which food security policies and programmes
are often based, given labour shortages arising from HIV/AIDS, drought,
migration and other factors. The issues of labour shortage and livelihood
insecurity and of food/livelihood security coping mechanisms of informal
rural institutions to HIV/AIDS impact are also examined.
Empowerment of rural women
Gender inequality facilitates the spread of HIV and exacerbates its impact.
This section examines: a) the gender-specific impact of young adult mortality;
the gender (and age/marital status) differentiated effects of HIV on household
income and expenditures; and c) the interface between formal and informal
rural institutions, gender and HIV/AIDS as manifested in traditional social
safety net mechanisms for women, such as widow inheritance, and the implications
of the adverse effects of such practices for women.
The heterogeneity of labour is highlighted as a critical factor in the analysis
of the impact of the epidemic. Human rights, production and productivity
issues, employment and labour market issues resulting from the impact of
HIV/AIDS are examined in terms of their policy and programme development
implications. More specifically: the role of the workplace in HIV prevention;
lost skills and experience; the substitutability of labour; losses in production
and rising payroll costs are analysed in the context of HIV/AIDS.
The implications of construction, maintenance and operation of rural infrastructure
are examined in terms of their potential positive or negative contribution
to the spread and impact of the epidemic. The impact of HIV/AIDS on rural
housing, and thus on rural living conditions, is also examined.
Participatory, gender-sensitive and multi-sectoral rural development policies
and programmes are essential elements of any response to HIV/AIDS. The need
to develop capacity-building strategies to improve the planning capabilities
of agricultural and rural development institutions and to help them cope
with the loss in human resources and other effects of the epidemic is underscored.
Rural institutional strengthening and capacity-building activities that
will also assist the case studies to generate policy and programme responses
may include one or several of the following components of the menu of options
- Rural development sector/sub-sector susceptibility/vulnerability
assessment (why and how is a sector/sub-sector vulnerable to HIV/AIDS?
which population/employee groups are most susceptible/ vulnerable? How do
labour conditions facilitate HIV transmission? etc.)
- Human resource needs/capacity assessment of public and private rural
development institutions, to evaluate the degree to which their policies
and programmes are aligned with the effects of the epidemic and with the
implications of human resource losses.
- Participatory training for rural institutions and their clients/target
groups in: bottom-up, cross-sectoral, gender-sensitive planning; the implications
of HIV/AIDS for rural development; and mechanisms that move field-based
information on the bi-directional relationships between HIV and rural development
up the planning ladder so as to influence how planners and policy-makers
think, how they plan responses and set policies.
- Policy/programme review (national and district level rural development
policies and plans, etc) to take into account the dynamics and impact of
the epidemic; to enhance multi-sectoral collaboration among rural development
programmes; and to integrate rural development programmes with HIV/AIDS
prevention and mitigation programmes.
- Creating a mandate on HIV/AIDS and generating political commitment
at the highest level for HIV/AIDS. Setting up a Management Information
System on HIV/AIDS in rural areas.
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