Health workers in 21 government health facilities in Zambia and South Africa linked spatial organisation of HIV services and material items signifying HIV-status (for example, coloured client cards) to the risk of People Living with HIV (PLHIV) ‘being seen’ or identified by others. Demarcated HIV services, distinctive client flow and associated-items were considered especially distinguishing. Strategies to circumvent any resulting stigma mostly involved PLHIV avoiding and/or reducing contact with services and health workers reducing visibility of PLHIV through alterations to structures, items and systems. HIV spatial organisation and item adjustments, enacting PLHIV-friendly policies and wider stigma reduction initiatives could combined reduce risks of identification and enhance the privacy of health facility space and diminish stigma.
Thought and commentary surrounding the upsurge of non-governmental organisations (NGOs) and their involvement in the design and implementation of development in the Global South are accompanied by an unrelenting set of contradictions and self-replicating inconsistencies. These are often embedded in the sector’s nomenclature, ideological underpinnings, intent and impact. Opposing bands of scholarship have sustained these tensions by securing NGOs both within the ambit of developmental thought and practice and also within the criticisms waged against western domination and its splinter models of modernity. In an attempt to extend these prevailing annotations, this paper holds the idealisation of NGOs up to scrutinous reflection within the context of Makhanda’s inequitable educational landscape by proposing that, in order to balance organisational uncertainties with the socio-economic urgencies upon which they trade, NGOs sustain several and, at times, competing affiliations all of which are central to organisational preservation and legitimacy. The tactical means by which organisations preserve these allegiances often deputise socio-economic and educational overhaul in favour of survival. Therefore, this article lays out the ways in which organisational urgencies intersect with contextually specific needs of reform in what becomes a zero sum of philanthropy and survival; this to the extent that, in large part, NGO interventions often serve to moderate, rather than uproot, the set of socio-economic features for which non-state intervention continues to be hailed and hallowed.
The primary feature of NGO development intervention is the role that organisations play in extending access to services and opportunities to marginalised populations. Participation, however, as an ideal and central organising principle in these efforts, comes with a host of complexities that requires careful navigation of the cross-cutting contexts within which organisations exist and function. This paper discusses the intricacies of NGO participation within the context of youth-centred initiatives carried out in Makhanda in South Africa’s Eastern Cape Province. In particular, the paper outlines the dynamics and trends of NGO participation among school-going and out-of-school youth living in a context of acute inequity and socio-economic exclusion. Data collected from young people, parents, teachers and community members in the Makhanda-east township of Joza, indicate that access to NGO services and consistent participation therein are differentiated and unequal in ways that sustain existing inequities in prospects and opportunity. A network of pre-existing features at an institutional, community, family and individual level sustains unequal access to non-state support that replicates dominant trends of inequity among the youth in this context. Consequently, this bears heavily on the choice and likelihood of who—among the youth in Joza—participates in NGOs; and more significantly, why, and why not? In an age where “popular participation” is heralded as the hope for a more egalitarian society, this paper proposes more careful consideration of the fact that NGO intervention exists within a dense and multi-layered network of inequities that, if not met with equally unbridled mediation, will persist and find refuge within a sector that seeks to confront the existing orders of inequity and exclusion.
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