Original Research

The process of developing distributed-efficacy and social practice in the context of ‘ending AIDS’

Christopher Burman, Marota Aphane, Robert Mamabolo, Oliver Mtapuri, Peter Delobelle
The Journal for Transdisciplinary Research in Southern Africa | Vol 11, No 1 | a31 | DOI: https://doi.org/10.4102/td.v11i1.31 | © 2015 Christopher Burman, Marota Aphane, Robert Mamabolo, Oliver Mtapuri, Peter Delobelle | This work is licensed under CC Attribution 4.0
Submitted: 24 February 2016 | Published: 31 July 2015

About the author(s)

Christopher Burman, Rural Development and Innovation Hub, University of Limpopo, Turfloop Campus, Polokwane, South Africa
Marota Aphane, Rural Development and Innovation Hub, University of Limpopo, Turfloop Campus, Polokwane, South Africa
Robert Mamabolo, Rural Development and Innovation Hub, University of Limpopo, Turfloop Campus, Polokwane, South Africa
Oliver Mtapuri, School of Built Environment and Development Studies, College of Humanities, Howard College Campus, Durban, South Africa
Peter Delobelle, School of Public Health, University of the Western Cape, Robert Sobukwe Road, Belville, Cape Town, South Africa

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Abstract

Introduction: this article reflects on data that emanated from a programme evaluation and focuses on a concept we label ‘distributed-efficacy’. We argue that the process of developing and sustaining ‘distributed-efficacy’ is complex and indeterminate, thus difficult to manage or predict. We situate the discussion within the context of UNAIDS’ recent strategy — Vision 95:95:95 — to ‘end AIDS’ by 2030 which the South African National Department of Health is currently rolling out across the country.

Method: A qualitative method was applied. It included a Value Network Analysis, the Most Significant Change technique and a thematic content analysis of factors associated with a ‘competent community’ model. During the analysis it was noticed that there were unexpected references to a shift in social relations. This prompted a re-analysis of the narrative findings using a second thematic content analysis that focused on factors associated with complexity science, the environmental sciences and shifts is social relations.

Findings: the efficacy associated with new social practices relating to HIV risk-reduction was distributed amongst networks that included mother—son networks and participant—facilitator networks and included a shift in social relations within these networks.

Discussion: it is suggested that for new social practices to emerge requires the establishment of ‘distributed-efficacy’ which facilitates localised social sanctioning, sometimes including shifts in social relations, and this process is a ‘complex’, dialectical interplay between ‘agency’ and ‘structure’.

Conclusion: the ambition of ‘ending AIDS’ by 2030 represents a compressed timeframe that will require the uptake of multiple new bio-social practises. This will involve many nonlinear, complex challenges and the process of developing ‘distributed-efficacy’ could play a role in this process. Further research into the factors we identified as being associated with ‘distributed-efficacy’ — relationships, modes of agency and shifts in social relations — could add value to achieving Vision 95:95:95.


Keywords

distributed-efficacy; complex adaptive systems; complexity & management science; environmental science; HIV/AIDS

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