Abstract: Availability, access and utilization of essential health services present challenges to community health services in Sub-Saharan Africa. HIV/AIDS infection has added yet another dimension to a continent already experiencing economic crises.
A primary prevention approach is emphasized as a means of addressing sexual behaviors that decrease risk of transmission. Educating the sexually active to use condom and also HIV/AIDS testing and counseling can be effective in curbing transmission of the virus. Community forums such as the local schools and churches, together with the political leadership need to coordinate primary prevention efforts against HIV/AIDS transmission.
The media can be powerful in raising awareness, community activism, and mobilization of the masses at grass-roots level by advocating behaviors that promote health. African leaders must indicate a strong political will by shaping policies that address HIV/AIDS. These leaders need resources (both internally and externally) to fund primary prevention programs that are community-based and outcome-oriented.
Key Words: Community Health, AIDS, Prevention, Africa.
Abraham Lincoln said that, "the dogmas of the quiet past are inadequate for the stormy present and future. As our circumstances are new, we must think anew and act anew." (Adapted from Clement-Stone, McGuire & Eigsti, 1998).
Availability, access, and utilization of essential health care services by all are basic human rights and not privileges. In the new millenium, communities all over the world will continue to battle social, economic, political, and technological challenges that may present themselves as opportunities to promote health and prevent communicable diseases. In most African communities, the medical and health care institutions in the past served as places where the sick and the frail went to receive treatment and cure for` various ailments in order to facilitate reintegration into mainstream society quicker. This conventional illness-- curative orientation in the demand for and delivery of health care services still persists in several sub-Saharan communities.
This paper presents a shift in perspective from an illness-- curative orientation to a primary prevention approach in the delivery of health care in sub-Saharan Africa. The concept of health is analyzed. The roles of community members, the African media and health policy in primary prevention initiatives as they pertain to the Human Immuno-Deficiency Virus /Auto-Immune Deficiency Sydrome (HIV/AIDS) in sub-Saharan Africa is examined. Implications of HIV/AIDS are examined in reference to the sub-Saharan context and the global community.
To put the concept of health in its proper context, a definition is in order. Many definitions of health exist. The World Health Organization preamble of 1948 defined health as "a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity"(Scutchfield & Keck, 1997, p.31). This definition laid a framework for action. By implication, it would also mean that since complete health is hardly attainable for any prolonged time frame, health attainment would require individual responsibility, autonomy of care, and the collective commitment of nations to strive toward the attainment of basic health care services. Secondly, this definition conceptualizes an holistic perspective of health as an amalgamation of several integral components that make up the whole.
Last (1997) argued that such a definition of health is vague, unattainable and immeasurable at any given time and place. A quantifiable definition of health was presented by Stokes, Noren, and Shindell (1982), as " a state characterized by anatomic integrity, ability to perform personally valued family, work and community roles; ability to deal with physical, biologic and social stress; a feeling of wellbeing; and freedom from the risk of disease and untimely death. …