ABSTRACT
OBJECTIVE: To describe the Strategy Results Cycle (SRC), a model that approaches planning as an ongoing cycle of seven phases that continually responds and adapts to existing evidence. MATERIALS AND METHODS: Reliable sources were used for the preparation of databases and expenditure-costing data for resources needs analysis. The planning process 6-9 months to complete a national strategic plan that was informed by evidence, focused on results and costed. RESULTS: Knowledge transfer facilitated national leadership and stakeholders' participation. Between 2007 and 2011, 13 of 16 countries adopted the Strategy Results Cycle model. The evidence supported the identification of results and the expenditure-costing analysis improved budget allocation efficiency. CONCLUSION: The SRC facilitated purposeful participation and added value to previous planning approaches by connecting "thinking" and "doing" which resulted in national strategic plans that are designed by stakeholders, relevant to local conditions, and can guide implementation and resource mobilization.
Subject(s)
HIV Infections/prevention & control , National Health Programs/organization & administration , Acquired Immunodeficiency Syndrome/prevention & control , Humans , Latin America , Models, OrganizationalABSTRACT
OBJETIVO: Describir el ciclo estratégico por resultados (CER), un modelo de planificación estratégica que aborda la planificación como un ciclo continuo de siete fases que responden y se adaptan continuamente a la evidencia. MATERIAL Y MÉTODOS: Se usaron fuentes fiables para la preparación de datos de base y datos de gastos-costos para el análisis de recursos. Se necesitaron de 6 a 9 meses para obtener un plan estratégico basado en evidencia, enfocado en resultados y costeado. RESULTADOS: La transferencia de conocimientos facilitó el liderazgo nacional y la participación de actores clave. Entre 2007-2011, 13 de 16 países adoptaron el modelo. La evidencia apoyó la identificación de resultados y el análisis de los gastos -costos mejoró la asignación presupuestaria. CONCLUSIÓN: El CER facilita la participación informada y añade valor a abordajes de planificación anteriores al conectar las "ideas" con la "acción", lo que resultó en planes estratégicos que fundamentan la implementación y la movilización de recursos.
OBJECTIVE: To describe the Strategy Results Cycle (SRC), a model that approaches planning as an ongoing cycle of seven phases that continually responds and adapts to existing evidence. MATERIALS AND METHODS: Reliable sources were used for the preparation of databases and expenditure-costing data for resources needs analysis. The planning process 6-9 months to complete a national strategic plan that was informed by evidence, focused on results and costed. RESULTS: Knowledge transfer facilitated national leadership and stakeholders' participation. Between 2007 and 2011, 13 of 16 countries adopted the Strategy Results Cycle model. The evidence supported the identification of results and the expenditure-costing analysis improved budget allocation efficiency. CONCLUSION: The SRC facilitated purposeful participation and added value to previous planning approaches by connecting "thinking" and "doing" which resulted in national strategic plans that are designed by stakeholders, relevant to local conditions, and can guide implementation and resource mobilization.
Subject(s)
Humans , HIV Infections/prevention & control , National Health Programs/organization & administration , Acquired Immunodeficiency Syndrome/prevention & control , Latin America , Models, OrganizationalABSTRACT
Over the last decade, international donors, technical specialists, and governments have come to recognize the potential of community-based organizations (CBOs) in the fight against HIV/AIDS. Recent empirical studies suggest that community engagement, including the involvement of CBOs, adds value to the national response to HIV/AIDS. With the emerging evidence of the effectiveness of engaging communities in the fight against AIDS, it is crucial to understand the economic dimension of community engagement. This article provides an analysis of funding and expenditure data collected from CBOs in three African countries: Kenya, Nigeria, and Zimbabwe. It presents descriptive information regarding CBO funding and expenditure and examines the factors associated with the total amount of funds received and with the proportions of the funds allocated to programmatic activities and program management and administration. An average CBO in the sample received US$29,800 annually or about US$2480 per month. The highest percentage of CBO funding (37%) came from multilateral organizations. CBOs in the sample spent most of their funds (71%) on programmatic activities including provision of treatment, support, care, impact mitigation, and treatment services.
Subject(s)
Community Health Services/economics , Delivery of Health Care/economics , HIV Infections/economics , Health Expenditures/statistics & numerical data , Organizations, Nonprofit/economics , Organizations/organization & administration , HIV Infections/prevention & control , HIV Infections/therapy , Humans , Kenya , Nigeria , Program Evaluation , Regression Analysis , ZimbabweABSTRACT
International donors have increasingly shifted AIDS funding directly to community-based organizations (CBOs) with the assumption that responding to the epidemic is best achieved at the community level. The World Bank, ICF Macro, and the National Council for Population and Development in Kenya, conducted a study to evaluate the community response in Kenya. The study used a quasi-experimental design comparing seven study communities and seven comparison communities in Nyanza Province and Western Province. We examined the impact of CBO activity on individual and community-level outcomes, including HIV knowledge, awareness and perceptions, sexual risk behavior, and social transformation (gender ideology and social capital). The study consisted of two components: a household survey conducted in all 14 communities, and qualitative data collected in a subset of communities. Individuals in communities with higher CBO engagement were significantly more likely to have reported consistent condom use. Higher CBO engagement was associated with some measures of social capital, including participation in local and national elections, and participation in electoral campaigns. CBOs provide added value in addressing the HIV and AIDS epidemic in very targeted and specific ways that are closely tied to the services they provide (e.g., prevention education); thus, increasing CBO engagement can be an effective measure in scaling up prevention efforts in those areas.
Subject(s)
Acquired Immunodeficiency Syndrome/prevention & control , HIV Infections/prevention & control , Health Knowledge, Attitudes, Practice , Organizations, Nonprofit/organization & administration , Program Evaluation/methods , Risk-Taking , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/psychology , Family Characteristics , Female , HIV Infections/epidemiology , HIV Infections/psychology , Health Surveys , Humans , Interviews as Topic , Kenya/epidemiology , Logistic Models , Male , Organizations, Nonprofit/statistics & numerical data , Prevalence , Qualitative Research , Residence Characteristics , Sexual Behavior , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
While communities have played a large role in the HIV/AIDS response, their contributions and innovative approaches to HIV prevention, treatment, care and support have not always been the focus of systematic and rigorous evaluations. To address this gap, the World Bank led an evaluation of the impact of the community response to HIV, including country studies in Burkina Faso, India, Kenya, Lesotho, Nigeria, Senegal, South Africa and Zimbabwe over a three-year period. Due to the complexity and varied nature of community responses, the evaluation attempted to determine the results that investments have produced at the community level by applying a mixed method approach: Randomized Controlled Trials, quasi-experimental studies, qualitative studies and analytical studies including financial data. Specifically, the studies examined a typology of community response and the flow of funds to community-based organizations, while investigating the impact of the community responses on (1) knowledge and behavior, (2) use of services, (3) social transformation, and (4) HIV incidence. This editorial summarizes the results of this evaluation portfolio, finding that investments in communities have produced significant results, including, improved knowledge and behavior, and increased use of health services, and even decreased HIV incidence. Evidence on social transformation was more mixed, with community groups found to be effective only in some settings. Each study in the evaluation provides a partial view of how communities shape the local response; however, taken together they corroborate the common wisdom that communities can be a vital part of the global HIV/AIDS response.
Subject(s)
Acquired Immunodeficiency Syndrome/prevention & control , Community Health Services/organization & administration , Community Networks/organization & administration , HIV Infections/prevention & control , Organizations, Nonprofit/organization & administration , Program Evaluation/methods , Acquired Immunodeficiency Syndrome/transmission , Community Health Services/statistics & numerical data , Developing Countries , HIV Infections/transmission , Health Services Accessibility , Humans , Risk Reduction Behavior , Social Change , Social Support , United NationsABSTRACT
Community-based organizations (CBOs) have emerged as a vital part of the response to HIV/AIDs in Nigeria. The evaluation, on which this article is based, conducted in 28 communities in 6 states and the Federal capital Territory in Nigeria, assessed the effects of the CBO engagement on a set of outcomes related to HIV/AIDS knowledge, attitudes, beliefs, and practices, stigma, service availably and utilization and social capital. It consisted of three components: a household survey conducted in all 28 communities, qualitative data collected from CBO staff and key informants (KIs), and a funding allocation study (qualitative interviews and the funding allocation study were conducted in a subset of 14 communities). This article focuses on the association between CBO engagement and reported availability and utilization of HIV/AIDS-related services. It shows that CBO engagement has a potential to add value to the national response to HIV/AIDS by increasing the awareness, availability, and utilization of HIV/AIDS-related services, especially in the area of prevention, care and support. The CBOs in the evaluation communities focused on prevention activities as well as on providing support for people living with HIV/AIDS (PLWHA) and prevention and care and support were the highest expenditure categories reported by CBOs. Respondents in communities with a stronger CBO engagement were more likely to: (1) be aware of any HIV/AIDs-related services, (2) report that prevention and care services were available in their communities, and (3) have used any HIV/AIDS related services, prevention-related and care-related services than respondents in communities where CBO engagement was weaker. The association between service awareness and service use and CBO engagement was stronger in rural than in urban areas.
Subject(s)
Community Health Services/statistics & numerical data , Community Networks/organization & administration , HIV Infections/prevention & control , Health Services Accessibility/organization & administration , Adult , Community-Based Participatory Research , Female , HIV Infections/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Interviews as Topic , Male , Middle Aged , Nigeria/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Program Evaluation , Qualitative Research , Residence Characteristics , Rural Population/statistics & numerical data , Social Facilitation , Social Stigma , Social Support , Socioeconomic Factors , Urban Population/statistics & numerical data , Young AdultSubject(s)
Aged , Humans , Aging/psychology , Geriatrics/education , Geriatrics/methods , Aged/physiology , Aged/psychology , Geriatric Psychiatry , Health of the ElderlyABSTRACT
Presenta un estudio de como es importante la nutrición para el desarrollo, como en la educación, población, salud, medio ambiente, agricultura, género, pobreza, en los momentos de crisis, derechos humanos, en las comunidades y en la política.
