1. The IMAGE Programme: A multi-sectoral partnership addressing poverty and gender inequality to reduce women’s risk of HIV and gender-based violence in South Africa.
IMAGE Project is a community based HIV and Gender based violence (GBV) prevention programme. It is a collaboration between The Small Enterprise Foundation (SEF), London School of Hygiene and Tropical Medicine (LSHTM) and the School of Public Health, University of the Witwatersrand. Based in rural South Africa, the intervention combined group-based microfinance with a 12-months gender and HIV training curriculum delivered to women at fortnightly loan repayment meetings. The purpose of IMAGE is to improve the economic well-being and independence of communities, reduce vulnerability to both HIV and gender-based violence, and foster robust community mobilization to address common concerns. The two components of the intervention are as follows:
1.1.The microfinance component
The microfinance component of the intervention is delivered in partnership with The Small Enterprise Foundation (SEF). SEF administers loans exclusively to poorest women in rural villages for the development of income-generating activities. The program targets the poorest households through a process of Participatory Wealth Ranking (PWR) - where local community members participate in wealth ranking of the households in their neighborhood. Those that fall below poverty line are invited to participate in the MF programme.
Based on the Grameen Bank model, groups of five women serve as guarantors for each other’s loans, with all five having to repay before the group is eligible for more credit. Loans are used to support a range of small businesses (e.g. selling fruit and vegetables, or second-hand clothes) and loan centers of approximately 40 women meet fortnightly to repay loans, apply for additional credit and discuss business plans. The microfinance component is financially self-sustainable – with the interest from loan repayments covering operating costs. Loan repayment rates are in excess of 99%. This microfinance component of the intervention facilitates social and economic well being and provides an entry point and client base for the SFL curriculum.
1.2.Empowering women leaders to catalyze broader activism and social mobilization
In addition to the microfinance component described above, the IMAGE intervention includes a participatory gender and HIV training programme called - Sisters For Life (SFL) which is fully integrated into routine loan centre meetings and is delivered alongside microfinance services by a separate team of trainers. SFL comprises of two phases delivered over 12 -15 months.
Phase One (first 6 months) consists of ten one-hour training sessions, and covers topics including gender roles, cultural beliefs, power relations, self-esteem, domestic violence and HIV. Participatory methods aim to increase confidence, communication skills and encourage critical thinking about the links between GBV and HIV.
Phase Two (Community Mobilization) encourages wider community mobilization to engage both youth and men in the intervention villages. Women deemed “natural leaders” by their peers are elected by loan centers to undertake a further week of training leadership skills and community mobilization. They return to their loan centers and over the subsequent 6 months, work with their centers to develop ‘village-level action plans’ that address a range of challenges including priority issues such as HIV and Gender Based Violence (GBV).
2. IMAGE: Rigorously evaluated and results-based
The IMAGE Project was rigorously evaluated from 2001-2005 as a research trial which compared villages receiving the full intervention package with a similar number of comparison villages. After two years, relative to matched controls, IMAGE participants showed impacts on:
a) Poverty: increased household expenditure and assets, and increased membership in savings groups;
b) Gender based violence: 55% reduction in risk of physical or sexual violence from an intimate partner
c) Women’s empowerment: improvement in self confidence, challenging gender norms, autonomy in decision-making, and collective action.
d) HIV risk - among young women participants, greater HIV communication with partners, accessing of Voluntary Counseling and Testing (VCT) services, and greater condom use (Pronyk et al. AIDS 22, 2008).
The evaluation also found that IMAGE loan centers can become a hub for community mobilization - participants successfully engaged with the broader community around a range of activities, public marches to raise awareness around issues of rape and domestic violence, HIV/AIDS, better access to ARVs and supply of female condoms; organization of village workshops and meeting with local leaders and the creation of village committees to target crime and rape. They also work with formal institutions such as the police and hospitals to demand better services that serve and protect the rights of women and girls.
2.1.Why add a Gender/HIV focus to economic development strategies?
A recent study of the relative benefits of IMAGE as compared to microfinance alone showed evidence of synergy across the Millennium Development Goals (MDGs). Researchers found that while microfinance on its own produced economic benefits, it was only the combined IMAGE model which facilitated wider gains in empowerment, social well-being and health - including the observed reductions in the risk of HIV and violence (J Kim et al, Bulletin of the World Health Organization 2009).
3. Looking to the future: Scaling up in South Africa and sharing best practices
Many programmes never make it beyond the pilot phase and remain “boutique” projects that do not get scaled up. Others have the stated intention of addressing gender inequalities and violence – yet have not been well evaluated. There is an increasing need to support programs that can transition from “proof of concept” to more sustainable interventions.
IMAGE is unique in that; because of its strong strategic cross-sectoral partnership with an existing and proven microfinance partner (SEF) , over the past decade since the original study ended, IMAGE project expanded from being a pilot project involving 800 women to scale up to reach at least 30,000 households across 3 provinces in South Africa. The results of the study have also led to national policy change and the formal inclusion of microfinance and the empowerment of women (i.e. addressing social and structural drivers of HIV) into the South African government’s Strategic Plan for HIV/AIDS (South African National AIDS Council’s (SANAC) Strategic Plan for 2007-2011 & 2012-2016).
As the first ever initiative proven to prevent intimate partner violence – levels of which are still inexcusably tolerated in South Africa - the project received global attention and spawned off-shoots in Burundi, Kenya, Tanzania and most recently Peru – where a major expansion supported by the InterAmerican Development Bank is currently underway.