Policy Briefing No.1
The full text (with graphics) of this International HIV/AIDS Alliance Policy Briefing, number 1 in a series, can be downloaded as a PDF (requires Adobe acrobat software) by following this link (file size 85kb).

From the Alliance’s experience, it is clear that there are many possible approaches and structures for supporting non-governmental organisations (NGOs) and communitybased organisations (CBOs) responding to HIV/AIDS. As a result, NGOs, CBOs, governments and donors are faced with a number of choices, each with their own challenges. This briefing provides an overview of these choices and challenges, and suggests solutions.

The International HIV/AIDS Alliance (the Alliance) is an international non-governmental organisation that supports communities in developing countries to make a significant contribution to HIV prevention, AIDS care and support to children affected by the epidemic. Since its establishment in 1993, the Alliance has provided financial and technical support to NGOs and CBOs from more that 40 countries. In addition, the Alliance promotes good practice in community responses to AIDS more broadly through evaluation, operations research, the development of training materials and tools, as well as policy and advocacy activities.

Key messages

• NGO/CBO responses are increasingly recognised as being crucial to successful action on HIV/AIDS. However, their capacity to deliver quality programmes is variable.

• To ensure that responses by NGOs and CBOs are sustainable, effective and can be scaled up, financial support needs to be accompanied by technical support, including monitoring and evaluation, and organisational development.

• There is a broad continuum of NGO/CBO support provision, ranging from ‘responsive’ support, based on the requirement for NGOs and CBOs to deliver on their own HIV/AIDS programmes, to ‘directive’ support, based on the requirement for NGOs and CBOs to deliver on the programmes of those providing the support.

• ‘Directive’ financial and/or technical support providers, particularly government based, need to build systems (such as participatory methodologies) into programmes in order to prevent them undermining the innovative and risk-taking nature of effective NGO/CBO responses to HIV/AIDS.

• NGOs and CBOs need to look beyond their own projects and work within national AIDS strategies in order to enable gaps to be identified, particularly in relation to highly affected and marginalised populations.

Why support NGOs and CBOs?
‘NGOs/CBOs understand better the different perspectives and operational experiences of working with communities, this in turn facilitates not only the designing of more responsive programmes but also encourages the communities to participate in planning and take action.’ MAMTA Health Institute for Mother and Child, India.

Since the beginning of the HIV/AIDS epidemic, NGOs and CBOs have been at the centre of the global response, providing a lead role in many countries in building effective strategies for HIV prevention, AIDS care and impact mitigation. In countries that have turned around major epidemics, such as Uganda, Senegal and Thailand, nongovernmental and community-based responses have played a long-standing and crucial part in this success. NGOs and CBOs are recognised as being innovative and uniquely placed to access communities affected by HIV/AIDS directly, particularly the most marginalised and vulnerable.

Although the importance of NGOs and CBOs in the response to HIV/AIDS is recognised with increasing financial support, there is also acknowledgement that the capacity of these organisations and the quality of their programmes may be variable. Therefore, there is a clear need for the funding of NGOs and CBOs to be matched by support to develop and strengthen their organisational and technical capacity. This is essential if they are to maximise their potential and achieve sustainability and scale-up of effective responses to HIV prevention, AIDS care and impact mitigation.

What constitutes NGO/CBO support?
In recognising the need for NGO/CBO support programmes, there are strategic decisions to be made about the type of support required. The Alliance’s experiences and analyses of NGO support programmes have identified a number of core components, activities and lessons learned.

NGO support components

Support for effective implementation
This involves encouraging and supporting NGOs and CBOs to implement quality, integrated approaches to prevention, care and impact alleviation projects. By working within national AIDS strategies, NGOs and CBOs can identify existing gaps, particularly in relation to highly affected and marginalised populations.

Support for scaling up

‘Scaling up is the process of reaching out to a wider community through effectively adapting existing programmes or organisations to meet changing needs.’ Participant in ‘Community Lessons, Global Learning’ workshop, India

Growing consideration is being paid to how to scale up effective NGO and CBO responses for a greater impact in preventing the transmission of HIV and mitigating its effects. Increasing funding is an obvious requirement. However, if the process of scaling up is not accompanied by technical support, including organisational development, there is a risk of compromising the quality and relevance of the work of NGOs and CBOs.

Key lessons learned on scale-up

• For effective scale up of NGO and CBO action there are minimum organisational requirements, such as solid administrative systems and capable leadership. Therefore, scaling-up programmes need to be backed by support for organisational development.

• Individual NGOs and CBOs can and should pursue their own targets and strategies if they are to continue to be effective and responsive to community needs. Scaling up NGO programmes within broader national and international strategies should recognise this important requirement.

Support for capacity building
This is a process whereby individuals, organisations and institutions are supported to address short-term weaknesses and, in the long-term, a process of enhancing existing strengths to achieve their mission and programmatic goals. This requires an integrated and holistic approach, acknowledging the importance of participation, strategic direction, technical HIV-related skills, knowledge and attitudes, and good organisational structures and procedures. With greater demands for NGO/CBO support programmes to produce results and visible impact, particularly from donors, it is important to recognise that capacity building is a long-term process that needs careful monitoring and evaluation.

Support for collective action on HIV/AIDS
Support programmes often provide a unique opportunity to bring together a number of NGOs and CBOs for joint activities, combining strengths, increasing cost-effectiveness, co-ordination and collaboration. This can help reduce duplication of effort, wastage of scarce resources and even provide economies of scale in procurement of HIV-related commodities.

NGO support functions

NGO/CBO support programmes can include a range of functions that aim to improve the effectiveness and impact of NGOs and CBOs: technical support, provision of grants, policy, advocacy and learning exchange, monitoring and evaluation, and research and resource mobilisation.
While NGO/CBO support programmes do not always need to include all of these functions, increasingly both government and non-government organisations are recognising that a more comprehensive package is often required. With increasing amounts of financial resources going to NGOs and CBOs, the need to build up the technical capacity of these organisations is paramount.

Technical support
‘Input provided to strengthen the programmatic work of individuals and organisations.’

Areas of input

• Technical aspects of HIV/AIDS, e.g. HIV prevention, AIDS care, working with vulnerable and marginalised groups.

• Programming, e.g. participatory community assessments, project design, monitoring and evaluation.

• Organisational development, e.g. governance, resource mobilisation and administration.

• Moral support and mentoring, e.g. providing advice and information, and sharing ideas.

Key lessons

• It is important to have a comprehensive package; organisational support is often neglected.

• Learning is most effective using a mixture of participatory techniques, direct guidance and information provision.

• Identify and build local expertise to ensure capacity building is relevant, ongoing and sustainable.

Who provides NGO/CBO support?
The increasing attention paid to the financial and technical support needs of HIV/AIDS NGOs and CBOs has led to the establishment and expansion of support programmes by a range of organisations and institutions. There is no single approach to providing such support: it varies according to the context, needs of constituents and capacity of organisations.

While the Alliance identifies NGO/CBO support providers as being any institution that tries systematically to provide financial and technical support to local NGOs/CBOs for HIV/AIDS work, it is recognised that some organisations provide only funding or only training. Therefore, support providers can take on any or all of the following identities:

• financial support providers

• technical support providers

• networks

• resource centres

• training organisations

• HIV-specific or broader health and development organisations.

Within these organisational identities, a broad continuum of support provision exists, ranging from ‘responsive’ support, based on the requirement for NGOs/CBOs to deliver on their own HIV/AIDS programmes, to ‘directive’ support, based on the requirement for NGOs/CBOs to deliver on the programmes of those providing the support. Although the majority of support providers tends to be based within an NGO, there are an increasing number that are operated by government bodies, donors or quasi-autonomous organisations.

NGO-based support
Stand-alone programmes

• Provide support to organisations with the aim of enhancing the effectiveness and impact of NGOs and CBOs.

• Do not implement HIV programmes.

• Often provide a combination of financial and technical support to partner organisations.

International and regional: International HIV/AIDS Alliance, Pact, Southern African AIDS Training Program.

National: Kimirina (Ecuador), ANCS (Senegal), KANCO (Kenya).

Implementing/ service organisations

• Direct service providers that also give support to others.

• Provide expertise, knowledge and skills from field experience to support others, often as part of a scale-up strategy.

YRG Care (India), Family AIDS Caring Trust (Zimbabwe), The AIDS Support Organisation (Uganda).

Networks

• Collaborating groups of individuals and/or organisations.

• Core mission does not always identify them as an NGO/CBO support provider.

• Can provide a venue and structure to communicate and share information, co-ordinate advocacy and enhance skills.

International Council of AIDS Service Organizations, Global Network of People Living with HIV/AIDS, Uganda Network of AIDS Service Organisations, Thai NGO Coalition on AIDS.

Training organisations

• Provide technical support on topics and skills.

• Solely provide training on specific issues, not necessarily on NGOs’ ongoing activities.

Regional AIDS Training Network, Organisation Development and Training, International Training and Research Centre.

Government-based support
Operating at multiple levels and through a variety of mechanisms, government-based support to NGOs can involve direct provision of funds and services or subcontracting to other organisations that provide this support. While remaining largely ‘directive’ support, this is a clear reflection of the increased recognition by governments and donors of the importance of community responses to HIV and the ongoing need for more support services.

Examples of financial support include the Government of Brazil in its Brazil II programme, which provides grants to NGOs nationwide through its NGO fund, and the UNAIDS Accelerated Programmes Fund. In India, NGO support via the government occurs at both the national and state levels through a complex mechanism of financial and technical support, co-ordinated by the National AIDS Control Organisation, involving the State AIDS Control Societies, Technical Resource Groups and multilateral and bilateral agencies.

Key Lessons learned from government-based support

• Effectiveness depends on the capacity of staff in government bodies to work with NGOs and CBOs.

• It is often better to have both NGO-based and government-based support programmes working together, rather than having one or the other.

• Many NGOs and CBOs work with marginalised and vulnerable populations, some of which engage in activities not recognised by law. Government-based support risks excluding these key populations.

• The autonomy and functionality of NGOs and CBOs must be recognised for them to remain innovative, risk taking and community driven, and in order to avoid them being merely subcontractors delivering government services.

• To facilitate more successful government–NGO partnerships, strategies need to be in place to overcome any legal barriers to government bodies providing support directly to NGOs and CBOs.

Further resources
For those who are establishing or seeking to improve HIV/AIDS NGO/CBO support programmes, the Alliance has developed an electronic library that broadly describes NGO/CBO support work, highlights the issues and provides resources relevant to an NGO support provider. This NGO/CBO Support Toolkit is available as a CD-ROM or can be found here.

International HIV/AIDS Alliance, Queensberry House, 104-106 Queens Road, Brighton BN1 3XF, United Kingdom Tel: +44 (0)1273 718 900 Fax: +44 (0)1273 718 901 E-mail: mail aidsalliance.org Websites: www.aidsalliance.org www.aidsmap.com Registered British Charity Number 1038860 July 2002

 

Alliance Policy Statements

Policy briefings

• Supporting NGOs and CBOs responding to HIV/AIDS
• Participation and empowerment in HIV/AIDS programming