Supporting community action on AIDS in developing countries

Costing Community Mobilization: An NGO Perspective

Jason Taylor Wright, MSFS, MAU.S. Director

International HIV/AIDS Alliance

Supporting community action on AIDS in developing countries

AIDS Alliance – Vision and Mission

• VisionA world in which people do not die of AIDS

• MissionTo support community action to prevent HIV infection, meet the challenges of AIDS, and build healthier communities

Supporting community action on AIDS in developing countries

AIDS Alliance – Structure

• International Secretariat

• 7 Technical Support Hubs

• 38 Linking Organizations

Supporting community action on AIDS in developing countries

AIDS Alliance – Strategic Responses

• Scale up integrated HIV programming• Support well-functioning community-

based organizations (CBOs)• Help form engaged, inclusive societies• Create a learning Alliance

Supporting community action on AIDS in developing countries

AIDS Alliance – 2011 Results

• 2,763,262 people reached through services• 3,660,516 people reached with IEC• 50,734,531 condoms distributed• 11,826 leaders reached through advocacy• 1,488 organizations supported financially

Supporting community action on AIDS in developing countries

AIDS Alliance – Previous Satellite Session

• Community Mobilization: A ‘Critical Enabler’ for Better Investment in HIV Programming• AIDS Alliance Executive Director Alvaro Bermejo• UNAIDS Director for Evidence, Strategy, and

Results Bernhard Schwartländer• AIDS Alliance Associate Director, Best Practice

Unit Christine Stegling

Supporting community action on AIDS in developing countries

Supporting community action on AIDS in developing countries

Value for Money (VfM) – Evolution

• Definition (2010)• Pilot studies in

India and Zambia (2010)

• Costing studies in Côte d’Ivoire (2010-2012)

• External engagement (mid-2011)

• Pilot study in Cambodia (late 2011)

• Costing of community mobilization (2012)

Supporting community action on AIDS in developing countries

VfM – Definition

• VfM seeks to judge the value of particular outputs, outcomes, or results against the cost of achieving them

• VfM can be increased in two main ways:• Increasing value• Reducing costs

Supporting community action on AIDS in developing countries

VfM – Practices

• Good practice standards and guides• Tools and guidelines• More analysis of unit costs

Supporting community action on AIDS in developing countries

Social Return on Investment (SROI)

• Adjusted form of cost-benefit analysis• Adaptation of UNAIDS costing toolkit on

HIV/AIDS facility-level services to community• (Positive and negative outcomes)/costs• Cost components measured:

• Organizational costs• Community costs

Supporting community action on AIDS in developing countries

SROI – Top-Line Results

• SROI is a relatively low-cost methodology for costing community mobilization

• We have structures for pricing community mobilization for 3 of the 6 basic program activities in the Investment Framework:• PMTCT (Zambia)• Key populations (Cambodia)• Behavior change programs (Kenya)

Supporting community action on AIDS in developing countries

SROI – Lessons Learned

• We were able to value what matters most to beneficiaries

• The SROI methodology can also be used in forecast studies for program planning

• There is a need to continuously adapt and improve the robustness of the methodology

• There are data challenges

Supporting community action on AIDS in developing countries

VfM – Words of Caution

• It is critical to avoid cost savings being achieved at the expense of increased costs for communities

• Community mobilization should not equate to a reduction in state or donor responsibility

Supporting community action on AIDS in developing countries

VfM – Words of Caution (cont.)

• The remuneration of community members should be included in program plans and budgets and technical guidance related to their roles

• We must understand VfM from a community perspective, i.e., we must better understand the meaning of whose value (and costs) count

Supporting community action on AIDS in developing countries

AIDS Alliance – Future Priorities

• We will continue to improve our efficiency• We will attempt to influence the VfM

debate with bilateral donors (DFID and PEPFAR), the Global Fund, and U.N. agencies (UNAIDS and the World Bank)

• We will conduct further studies using the SROI methodology

Supporting community action on AIDS in developing countries

AIDS Alliance – Resources

• Measuring and Improving the Value for Money of HIV Programming (December 2010)www.aidsalliance.org/publicationsdetails.aspx?id=505

• SROI: CHAHA (Children Affected by HIV/AIDS) Programme (March 2011)www.aidsalliance.org/publicationsdetails.aspx?id=90518

• “Doing More with Less:” SROI: Evidence Based Operational Research on KHANA Integrated Care and Prevention Program in Cambodia (April 2012)www.aidsalliance.org/publicationsdetails.aspx?id=90580