HIV/AIDS-related funding to faith-based organizations in sub-Saharan Africa: qualitative systematic review

Inghepa, Klaudia

HIV/AIDS-related funding to faith-based organizations in sub-Saharan Africa: qualitative systematic review

Thesis / Dissertation

2026

Publisher

University of Cape Town

Department

Department of Public Health and Family Medicine

Faculty

Faculty of Health Sciences

Abstract

Introduction: HIV/AIDS remains a global crisis, with 84.2 million infections and 40.1 million deaths since 1996. Despite initiatives like the UNAIDS's 95-95-95 strategy to end AIDS by 2030, sub-Saharan Africa bears two-thirds of the global burden. Effective HIV prevention requires integrating biomedical, behavioural, and structural approaches. Faith-Based Organizations play a pivotal role in delivering affordable, community-accepted health promotion services. However, challenges such as inadequate funding and technical capacity limit their ability to conduct awareness campaigns, distribute educational materials, and provide HIV testing and counselling. This study explores how Faith based organisations in subSaharan Africa accessed global and local HIV/AIDS funding from 2000 to 2024. Methods: A qualitative systematic review as conducted in two phases, first phase consisted of a scoping review (Phase 1) which then informed the qualitative systematic review (Phase 2). Qualitative and quantitative data was extracted from primary studies to identify funding mechanisms of Faith Based Organizations in HIV/AIDS engagement, barriers and facilitators over two decades. Grey literature, such as case studies and government reports, supplemented this review. Searches conducted in databases like PubMed and EMBASE focused on English-language studies from 2000–2024. Screening included titles, abstracts, and full texts, with data analysed using descriptive and thematic synthesis. Findings: Nineteen records, including primary studies and reviews, were included. Most studies reported on Christian Faith Based Organizations, primarily Catholic churches, offering services spanning education, health, psychosocial support, and economic empowerment. The review highlights that faith-based organizations in sub-Saharan Africa are not receiving sufficient HIV/AIDS-related funding, despite their critical role in healthcare delivery, particularly in rural and underserved areas. Structural and administrative barriers limit their ability to access and manage funds effectively, including capacity constraints in financial management and compliance with donor requirements. Furthermore, the finding raises concerns about the potential complete withdrawal of United States government funding following policy shifts under President Donald Trump's administration. This anticipated funding cut threatens to further weaken the already limited financial support for Faith based organisations-led HIV interventions, potentially disrupting essential services such as HIV prevention, treatment, and care programs. These findings underline the urgent need for capacity-building efforts to enhance Faith Based Organizations' financial and administrative capabilities, as well as the importance of diversifying funding sources to reduce reliance on a single donor, ensuring the sustainability of HIV/AIDS interventions in the region. Conclusion: This review highlights the significant funding challenges faced by faith-based organizations in sub-Saharan Africa in their efforts to combat HIV/AIDS. Despite their crucial role in healthcare, Faith Based Organizations remain underfunded and lack financial management capacity. In addition, the potential withdrawal of U.S.A government funding further threatens their sustainability. To address this, urgent action is needed to strengthen these organization's financial and administrative capacity and explore alternative funding mechanisms. Policymakers and donors must recognize their role and support a more sustainable funding framework to prevent disruptions in HIV/AIDS services, particularly in communities dependent on faith-based healthcare.