Healthlink Worldwide

This 4-page learning paper, published by Healthlink Worldwide, considers how memory work makes a difference in people's lives, how issues around sustaining and scaling up the approach are important to its continuation, and why, even with increased access to anti-retroviral treatment, memory work is still important to continue. According to the paper, memory work is critically important in the fight against HIV and AIDS at community level in several African countries. Hundreds of families are benefitting from the approach, with parents finding the ability to disclose their status, seek out care and support, and prepare for their children’s future.

The paper defines memory work as a psychosocial intervention for families affected by HIV/AIDS that promotes open communication in a safe environment, and allows people to become confident enough to disclose their status to family and other community members. Tools used in the approach include a memory book or box where family history, wills, and succession plans are written down and kept for children. According to the paper, key elements emerging from the interventions include communication skills; child development and parenting; disclosing HIV status; coping with emotions such as loss and bereavement; planning for the future; and legal support.

The paper looks at how organisations can make memory work sustainable. This includes integrating it into other programmatic approaches; training staff in implementing the approach; and advocating its importance to donors. It also includes recommendations for scaling up the approach, including training more beneficiaries in communities to implement it; incorporating more training of vocational skills; strengthening capacity of small non-governmental organisations and community-based organisations to use it; conducting advocacy around the approach at national level; and including income generating activities to widen the scope of support.

The report also looks at key challenges to implementing memory work, as well as ways to support organisations who want to use the approach. It identifies three main areas for support: advocacy, training, and capacity building.

The paper concludes by discussing the future directions for memory work and identifies 4 main themes:

• Advocacy: This includes advocacy in the community, as well as the national and international level so that memory work is recognised, supported, and implemented.
• Scaling up children's participation: The paper identifies a number of activities to further involve children, as well as integrate sexual and reproductive health in memory work. Developing the approach for specific populations such as very young children or internally displaced people are also possibilities.
• Mainstreaming: According to the paper, mainstreaming is seen as a way to maintain and increase the effectiveness of memory work.
• Income generating activities: Incorporating income generating activities is seen as a means to address both livelihood and psychosocial aspects, thus providing a more holistic response.

Healthlink Worldwide website on March 16 2009.