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close this bookVolunteer Participation in Working with the Urban Poor (UNDP - UNV, 64 p.)
View the document(introduction...)
View the documentIntroduction
View the documentNote on terminology and abbreviations
View the documentSummary
close this folderI. Urbanisation: recognition and response
View the document(introduction...)
View the documentUrbanisation and poverty
View the documentResponse to urbanisation
View the documentRecognition of ''Self-help'' initiatives
close this folderII. Insights derived from community-based programmes
View the document(introduction...)
close this folderUrban informal sector
View the document(introduction...)
View the documentMicro-enterprise promotion
View the documentWorking conditions in the informal sector
View the documentThe ILO experience
View the documentLow-income housing
View the documentInfrastructure and basic services
View the documentHealth and HIV/AIDS prevention
View the documentNon-formal education and functional literacy
View the documentWomen, gender and development
View the documentChildren of the street
View the documentImplications for VSAs
close this folderIII. Towards a community-based strategy for VSAs
View the documentParticipation: how and for whose benefit?
View the documentA sense of ''community''
View the documentGeneral characteristics of low-income urban communities
View the documentFactors determining support possibilities
View the documentGeneral characteristics of CBOs
View the documentSupport channels and intermediaries
close this folderIV. Programming concerns for VSAs and UNV
View the documentGuidelines for involvement
View the documentSuccess criteria for volunteer involvement
View the documentTaking the initiative
View the documentFlexibility
View the documentMeeting personnel and associated needs
View the documentChannels of operation
View the documentUnited Nations Agencies and their partners
View the documentFunding and other programme concerns
close this folderV. Principles and characteristics of volunteer use
View the documentFunctions and volunteers
View the documentQualities of VDWs
View the documentTeams
View the documentSkill requirements and experiences
View the documentSelection and placement process
View the documentAcculturation and language training process
View the documentEpilogue: follow-up, 1995
View the documentAnnotated reference list
close this folderAnnex: Excerpts from background papers
View the documentUrban development policy issues and the role of united nations volunteers
View the documentWorking with the urban poor: lessons from the experience of metropolitan Lagos, Nigeria
View the documentBrief account of my experience as a DDS field worker and a UNV in Sri Lanka and Jamaica
View the documentSpecial consultation on volunteer participation in working with the urban poor

Health and HIV/AIDS prevention

WHO, like UNICEF and other organisations such as UNFPA, has espoused a community-based approach to the problem of low-income urban groups for many years. Its principal strategy for this work is emphasis on Urban Primary Health Care (PHC), which draws upon many of the same features as the regular rural PHC approach. The principles for community participation are similar to the ones described above. Aside from the difficulty of securing community participation in health-related work, there is a further issue which complicates this work, and the lives of low-income urban groups: the epidemic spread of the HIV/AIDS virus in developing countries. Awareness of the magnitude and socioeconomic impact of this pandemic has grown only recently.

According to WHO estimates of the 20 million people worldwide infected by the human immuno-deficiency virus (HIV), about half of them are expected to develop AIDS within the next few years. Almost 85% of these people live in urban areas. Studies show that low-income urban groups are particularly vulnerable to this virus.

While women and men are affected in almost equal numbers, HIV prevalence is higher among women in the high fertility 15-20 age-bracket. Infant mortality rates rise sharply through infected mothers and foetal transmission. The impact of HIV/AIDS on low-income groups is disastrous. The most productive adult members are the first to disappear, and the economic burden on survivors - particularly orphaned children and the elderly - becomes untenable. In one small African city, it is estimated that the epidemic will have produced 120,000-160,000 orphans by 1995. Even community support arrangements will be unable to provide for such a large number of destitute children.

An associated problem is the spread of AIDS-related diseases, such as tuberculosis. Unsanitary and overcrowded conditions in low-income urban settlements create a conducive environment for the rapid spread of highly-infectious diseases. Estimates show that communicable diseases have quadrupled in some cities with the onset of HIV infection.

Another indirect impact of HIV/AIDS is the burden it presents on the provision of general health services. Persons with AIDS continue to absorb a greater proportion of the total health care resources available. The pandemic has also seriously affected the outreach of child immunization, nutrition programmes and diarrhoea and TB prevention.

The strain on the maintenance of community-based social welfare structures in low-income urban settlements will soon become intolerable. It is with concern for these individuals and others that UNV, in cooperation with UNDP and WHO, developed its community-oriented programme for using UN Volunteers in HIV/AIDs-related work. Based on a mixed-team approach which uses UNV Specialists, DDS field workers and local community workers, UNV has found that VDWs can play a substantial role in strengthening NGO and community-based activities through training, coordination and resource mobilisation, focusing on social aspects and prevention measures to deal with the epidemic. In Zaire, for example, various church groups such as the Eglise du Christ au Zaire and the Red Cross, small women's groups such as Mamans Catholiques and Maman Kambangiste, and even farmer cooperatives and youth groups -are all working to address counselling needs, develop group information sessions, and find ways of alleviating poverty and extending family incomes beyond extremely low levels. VDWs can play a key role in further extending these "self-help" efforts in addressing concerns related to HIV/AIDS.