The Development of a Framework to Evaluate the Management of HIV/AIDS Programmes in Rural and Urban South Africa

Abstract

Nearly 40 million people worldwide are living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), with just 12% of those who urgently need treatment receiving it. South Africa has one of the highest cases of HIV infections in the world. Intervention efforts have not kept pace with the spread of HIV/AIDS, and a knowledge divide has been identified as a major factor in this. An initial empirical investigation suggests that HIV/AIDS organisations are working individually to address the problems, but there is no overall coordination between them, no system to share knowledge, and the organisations compete for the same funds. The result of this could be wasted resources and a systematic and systemic approach may assist in achieving better results. As mentioned above, a knowledge divide has been identified, and knowledge sharing between HIV/AIDS organisations is at best unplanned and at worse simply does not happen. Given these things, knowledge management would appear to be able to offer some ways forward. Combining systems thinking with knowledge management offers a powerful approach to addressing these issues. By using a hierarchy of systems complexity it may be possible to identify where approaches and possible solutions to problems have been incorrectly specified because they are addressing the wrong level. In this context, the right level refers to approaches of information technology, information systems and knowledge management. This chapter explains the background to HIV/AIDS in South Africa and the issues involved in addressing the management of HIV/AIDS programmes. The chapter outlines how these may be approached by using the concepts of knowledge management, systems thinking and the seven wastes of lean.