“whose value counts”: a community perspective on value for money

Supporting community action on AIDS in developing countries

Liza TongProgramme ManagerInternational HIV/AIDS Alliance

“Whose Value Counts”: A community perspective on value for money


Presentation outline

1.The Alliance2.Value for money – our

approach so far3.Community mobilisation and

growing trends 4.Costing community

mobilisation5.What next?

Questions and Discussion


A global partnership of 36 independent linking organisations

Secretariat ‘added value’ (as defined by Alliance linking organisations): - knowledge & capacity building, policy influence, resource mobilisation,

credibility & prestige and protection


The Alliance model:

:• International Secretariat

1 Knowledge & capacity building2 Policy influence 3 Resource mobilisation4 Credibility & prestige5 Protection

• 37 linking organisations

• 7 TS Hubs

Technical & financial

assistance, & HIV prevention,

care & support services

• 2,000 community based organisations HIV

prevention, care &

support services

• 2.9 million people reached (2010)

Vision: a world in which people

do not die of AIDS

Mission: supporting community action to prevent HIV infection, meet the challenges of AIDS & build healthier communities


Nov 2010mid 2010

VFM evolution

VFM definitions

Pilot SROI India/Zambia

2010-2012

Costing studiesWest Africa


Nov 2011Jul 2011

VFM evolution

External engagement

SROI Cambodia

2012

Costing community mobilisation


local com

munity res

ponsibility

• Increasingly direct and non direct services provided by community, either as family members, volunteers, PEER/ community group leaders

International

and National

level

influen

ce

• Donors, implementing governments, and NGOs slowly recognising importance of paying and extending social protection

• Increasing discussion about the potential benefits of large scale community healthcare worker programmes

Com

munity mobili

sation

achieves

scale

• Evidence shows HIV related community services play a significant role helping to scale up antiretroviral (ARV) treatment and TB therapy, MNCH, SRH as well as linking patients to prevention care and testing

Community mobilisation and growing trends


Important words of caution concerning community mobilisation and the drive for VFM• Critical to avoid cost savings for donors being achieved

at the expense of increased costs for communities.• Community mobilisation should not equate to a

reduction in state or donor responsibility, • Governments, donors, and international institutions

should include costs and strategies for the remuneration of community members in budgets, programme plans, and technical guidance related to their role

• It is vitally important that we understand VFM from a community perspective – in other words better understanding the meaning of whose value (and costs) count


Costing community mobilisation • IHAA lead investigator

UNAIDS funded study• To generate more

information about the methods to capture and understand cost data for CM within the HIV AIDS response – Little out there exists!

• Audience for study : IHAA network, national LOs and their CBO implementing partners, UNAIDS secretariat and COs


What did we do?

• Used a common approach (UNAIDS costing toolkit on HIV/AIDS facility level services) adapted for community services

• Priced CM within PMTCT, prevention with key populations, Behaviour change

• Defined service chain for each area and unit cost /person reached


Organisational cost

• Direct and indirect program cost of community mobilisation

• Cost at national NGO level• Cost of CBO• Cost of implementing

network

Community cost

• Cost to the community (community health worker, PEER educator, familiy member, village leader etc) in participating as volunteers, facilitators, beneficiaries

Cost components measured


Community cost resultsResult costed Programme

descriptionCost per person reached Organisational

Cost per person reached Community

PMTCT in Zambia

Community awarenessDramaPer educator trainingSafe motherhood groupsIECBreastfeeding campaign

$21 $3.29


Community cost resultsResult costed Programme



Prevention HIV among sex workers in Cambodia

Referrals and servicesClients and sweethearts programsDrop-in centresSelf-help and support groups BCC

$170 $7.34


Community cost data Result costed Programme



Positive prevention Kenya

Health worker training (youth friendly)Prevention messagingBCC HIV free generationTreatment literacy

$64 $4.3


Top line results of the study• The development of a comparatively low cost

methodology for costing community mobilisation that civil society organizations and planners are able to test and apply in other settings

• A structure for pricing community mobilisation as it relates to three specific types of HIV programme activities. These included prevention to mother to child transmission (PMTCT); focused prevention with key populations; and behavior change communication (BCC).

• Pricing (unit costs per person reached + sample activity costs) of community mobilisation for PMTCT in Zambia, focus prevention activities with key populations in Cambodia, and BCC in Kenya.


What’s next?• Focus efforts on building capacity for this work

in partner organisations • Capturing examples of countries that will

integrate costing/cost benefit work into their systems for year on year cost efficiency

• Working with countries to maximise the use of this work i.e. KHANA VFM policy brief, Thogomelo SA. SROI research and advocacy


THANK YOU!

“whose value counts”: a community perspective on value for money

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