Investing in Communities Achieves Results: Findings from an Evaluation of Community Responses to HIV and AIDS

by Rosalia Rodriguez-Garcia, Rene Bonnel, David Wilson, N'Della N'Jie

Overview

Investing in Communities Achieves Results fills an important gap in the global knowledge on community level results and resources related to HIV and AIDS. While communities, in spite of their limited resources, have played a key role in the HIV/AIDS response, their contributions and innovative approaches to prevention, treatment, care, and support have not always been the focus of systematic and rigorous evaluations. To address this deficit, a series of studies-including evaluations in Burkina Faso, India, Kenya, Lesotho, Nigeria, Senegal, South Africa, and Zimbabwe-were undertaken over a three-year period (early 2009 to early 2012), helping to build a robust pool of evidence on the effects of community-based activities and programs. A unique feature of this multicountry evaluation was the collaboration between two international organizations (the World Bank and the United Kingdom's Department for International Development) and a major civil society network (the U.K. Consortium on AIDS and International Development). Other attributes that contributed to the successful outcome were the sustained consultation process with civil society and stakeholders at the local, national, and global levels, and the collaboration among high-caliber, multi-disciplinary researcher teams. The book's findings are promising. At varying levels, depending on the country context, the HIV response in communities was shown to improve knowledge and behavior and increase the use of health services- and even decrease 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 constitute a significant pool of rigorous evidence on the contributions of communities, community groups, and civil society to the national and global HIV and AIDS response. The studies suggest that communities have produced significant results at the local level, which contribute to outcomes at the national level.

Product Details

ISBN-13:	9780821397411
Publisher:	World Bank Publications
Publication date:	01/22/2013
Series:	Directions in Development - Human Development
Pages:	144
Product dimensions:	6.80(w) x 10.00(h) x 0.30(d)

Table of Contents

Acknowledgments xi

Abbreviations xiii

Overview 1

Abstract 1

Introduction 1

Background 1

Context and Evaluation Questions 2

Audience 3

Methodology 3

Findings 4

Discussion 10

Policy and Programmatic Implications 10

Resource Implications 14

Research Implications 15

Conclusions 16

Notes 17

References 17

Chapter 1 Introduction 21

Abstract 21

Introduction 21

Substantial Investments 22

Diverse Roles of Communities 23

Communities and Government Programs 24

Need for Evidence 24

Evaluating the Community Response 25

Notes 26

References 27

Chapter 2 Approach and Methodology 29

Abstract 29

Introduction 29

Objectives 29

What Is the Community Response? 30

Communities: The Typology Challenge 31

A Mixed-Method Approach 32

Conceptual Framework of Community Responses 36

Note 38

References 38

Chapter 3 Key Findings and Cross-Cutting Issues 41

Abstract 41

Introduction 41

Findings: Resources Available at the Community Level 43

Findings: Effects of the Community Response 47

Notes 63

References 64

Chapter 4 Overview of Country Evaluation Cases 67

Abstract 67

Introduction 67

Burkina Faso 67

India 71

Kenya 73

Lesotho 76

Nigeria 77

Senegal 79

South Africa 81

Zimbabwe 82

Overall Conclusions 83

Notes 83

References 84

Chapter 5 Features of Successful Community Responses 87

Abstract 87

Introduction 87

Type and Stages of HIV Epidemics 87

Alignment and Linkages with the AIDS Response 88

National Policies in Support of Community Action: Legal, Social, and Political Environment 89

Characteristics of Communities and Community Organizations 89

Note 92

References 92

Chapter 6 Conclusion and Recommendations 93

Abstract 93

Introduction 93

Evaluation Summary 93

References 97

Appendix A Evaluation Teams and List of Study Reports 99

Abstract 99

Introduction 99

World Bank Evaluation Team 99

Country Evaluation Teams and Reports 99

Desk Studies and Background Papers 102

Country Briefs and Evaluation Summaries 102

Appendix B Peer Consultations 103

Abstract 103

Peer Reviewers 103

Africa 103

Asia 103

Europe 104

Latin America 104

Middle East and North Africa 104

North America 104

International Agencies and Foundations 104

Appendix C Evaluation Approach and Methods 105

Abstract 105

Introduction 105

Goal 105

Approach and Guiding Principles 105

Evaluation Design 106

Evaluation Framework 110

Consultative Process 112

Limitations 112

Note 113

Bibliography 113

Appendix D Design and Methods of Country Evaluations 115

Abstract 115

Summary 115

References 123

Boxes

2.1 Definitions 30

3.1 The Role and Importance of Volunteers in Kenya, Nigeria, and Zimbabwe 47

3.2 Classification of the Strength of the Evidence 50

3.3 What Are the Pathways between Community Group Membership and Health? 53