ALAFA has played vital roles in the fight against HIV/AIDS. To begin with, the alliance has been raising funds from factory owners and other donors to help in sensitizing workers against the dangers of contracting HIV/AIDS. For instance, numerous peer educator programs are organized around workplaces. Peer educators are fellow factory workers who are trained on topics such as HIV/AIDS prevention and treatment, family planning and healthy relationships.
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They are then expected to pass the same knowledge to their fellow workers. In addition, ALAFA has set up clinics in workplaces so that those who test HIV positive can receive treatment easily instead of travelling long distances to seek for the same services. Three main areas of focus for ALAFA are testing, prevention and treatment. Factory workers in the apparel industry are the main target group.
The issue of HIV/AIDS is crucial to ALAFA because it has reached an alarming level. It is tearing down the very workforce that is needed to build the economy of Lesotho. Besides, HIV prevalence in the clothing factories is very high. ALAFA is worried that unless urgent mitigation measures are put in place to curb the spread of HIV/AIDS, the entire Basotho population might be wiped out in a few years to come. For example, close to 270,000 adults had been infected by the scourge in 2009. That represented 22 percent of the adult segment of the Basotho population (Gilden, 2009).
The ALAFA intervention has addressed a number of economic and social factors in regards to testing and treatment of the disease. First, testing of the vulnerable population came at a time when there were no adequate funds. Hence, the alliance organized for several donation drives before starting the program. Some of the donors to the alliance include large scale apparel buyers in the United States, factory owners, external international donors and even the Lesotho government.
In regards to poor organization of the testing and treatment program that had existed before, ALAFA decided to train peer educators as well as hire nurses and pay them as they discharge their duties in the established clinics. The doctors who offer treatment at the factory-based clinics are also hired and paid by ALAFA. Hence, the economic disease burden is not left to the ailing population.
The program also addresses a number of cultural barriers such as stigma and unwillingness to be tested. Moreover, the Basotho people are culturally conservative (Gilden, 2009). As much as they are sexually active, they find it quite difficult to discuss sexuality in an open manner. Through peer education and community outreach to individual families, ALAFA has managed to intervene appropriately towards the above barriers.
The peer educator model is indeed an effective education strategy because the targeted group feels safer and ready to share their experiences when they are taught with their trained colleagues. Second, peer education is relatively cost-effective as compared to hiring en external team of educators (Harrison, Short, & Tuoane-Nkhasi, 2014). Third, the model breaks most of the cultural barriers (such as language) that may hinder smooth transfer of knowledge.
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In determining the cost-effectiveness of this program, I would begin by assessing the cost of setting up and running the factory-based clinics (such as the infrastructure, medicines, and salaries for nurses and doctors). Revenue generated by ALAFA itself (in form of donations) should also be considered (Raczynski & DiClemente, 2013). Besides, the productivity of workers who are undergoing treatment should be factored in the assessment. Finally, sustainability of the program in the long term and the number of years the ailing workers will be employed in the apparel industry should be considered so as to find out if it will be cost-effective both for donors and the clothing factories.
Gilden, D. (2009). Case Studies for Global Health: Lesotho Apparel Industry Unites to Fight AIDS. Web.
Harrison, A., Short, S., & Tuoane-Nkhasi, M. (2014). Re-focusing the Gender Lens: Caregiving Women, Family Roles and HIV/AIDS Vulnerability in Lesotho. AIDS & Behavior, 18(3), 595-604.
Raczynski, J. M., & DiClemente, R. J. (2013). Handbook of health promotion and disease prevention. New York: Springer Science & Business Media.