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A Question of Scale - contents, publication details
   Last updated: 16.08.02
A Question of Scale?
The challenge of expanding the impact of non-governmental organisations’ HIV/AIDS efforts in developing countries

By Jocelyn DeJong

The full version complete with graphics (as a PDF file, which requires Adobe Acrobat) is available by following this link (file size 1.43 Mbytes).

Abbreviations, Acknowledgements

i. Background and Definitions

1. Introduction to A Question of Scale?

2. Why Scaling Up is Important

3. The Need and Urgency to Scale Up in HIV/AIDS

4. What is Meant by “Scaling Up” in Development?

5. Defining Scaling Up in the Context of AIDS: Different Perspectives
  • Impact

6. Scaling Up as a Process
  • A Dynamic Relationship Between Prevention, Care and Mitigation

7. Is there Necessarily a Trade-Off Between Expansion and Maintaining Quality?

ii. Strategies

8. The Development Literature on Scaling Up: Relevance to HIV/AIDS

9. A Proposed Typology of Scaling Up with Application to HIV/AIDS
9.1. Strategy 1: Organisational Expansion
9.2. Strategy 2: Catalysing Other Organisations
a) Technically; b) Financially
9.3. Strategy 3: Diffusion
9.4. Strategy 4: Influencing Policy/Legislation
9.5. Strategy 5: Mainstreaming in Development
9.6 TASO: An Example of the Evolution of Scaling Up Strategies

10. Partnerships/Alliances
  • Government-NGO Relations

  • NGO-CBO Relations

11. The Importance of Context

12. Decisions as to Whether or Not to Scale Up

13. What is the Motivation for Scaling Up?

14. Risks Entailed in Scaling Up NGO Efforts

15. Special Challenges in Scaling Up HIV/AIDS Efforts
  • Donor Funding

  • Cultural and Political Resistance

  • Greater Visibility

  • Promoting “Community Participation”/Facilitating Community Response

  • Incorporating Diversity

  • The Pace of Scaling Up

iii. Institutional Implications of Scaling Up

16. Internal Dimensions of Scaling Up


  • Changes in Institutional Culture and Processes

  • Involvement of Volunteers

  • Leadership

  • Capacity

17. Implications for Donors and NGO-Support Organisations

18. Conclusion

Appendix Section

Appendix: A

Case Studies from Scaling Up Seminar sponsored by HORIZONS and the International HIV/AIDS Alliance

Scaling-up Asociacion de Salud Integral (ASI)

Family Health Trust – Zambia

South India AIDS Action Programme (SIAAP): Its Role, Growth and Development in Meeting the Challenge of HIV/AIDS

Cambodia Home Care Programme

The Salvation Army’s “Concept Transfer” Approach to Scaling Up

Naz Foundation (India) Trust: An Implementer’s Perspective of the Highways Project

Scaling up the FOCUS Programme of Family AIDS Caring Trust

PACT AIDS Corps

The Kenya AIDS NGOs Consortium (KANCO)

Project Support Group (PSG)

Appendix: B

Potential Target Groups for HIV/AIDS Interventions and Prevention, Care and Support Activities According to Need, Complexity and Cost

Table 1:Potential Target Groups for HIV/AIDS Interventions and Activities

Table 2: Care and Support Activities, by Need, Complexity and Cost

Appendix: C

International HIV/AIDS Alliance, 1993-2000

Table 1: Main community level responses supported by the Alliance in the start-up phase 1994-6

Table 2: Pilot projects 1994-97

Appendix: D
List of Participants [only included in pdf version of this report]

References for A Question of Scale?

Publishers and funders

Horizons

4301 Connecticut Ave NW, Suite 280, Washington DC 20008, USA

International HIV/AIDS Alliance

Queensberry House, 104-108 Queens Road, Brighton BN1 3XF, UK

USAID. This activity was supported by the Horizons Programme and the International HIV/AIDS Alliance. Horizons is funded by the U.S. Agency for International Development, under the terms of HRN-A-00-97-00012-00. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for International Development. August 2001.

Population Council. The Population Council is an international, nonprofit, nongovernmental institution that seeks to improve the wellbeing and reproductive health of current and future generations around the world and to help achieve a humane, equitable, and sustainable balance between people and resources. The Council conducts biomedical, social science, and public health research and helps build research capacities in developing countries. Established in 1952, the Council is governed by an international board of trustees. Its New York headquarters supports a global network of regional and country offices. Copyright © 2001 The Population Council Inc.

Further publication
A book developed from the work of this report will be published by ITDG Publishing in 2002 entitled A Question of Scale: Expanding NGO Impact in HIV/AIDS by Jocelyn DeJong. ISBN 185339 496 3. For further details, please contact the Marketing Department at ITDG Publishing, 103-105 Southampton Row, London WC1B 4HL, United Kingdom, tel +44 (0)20 7436 9761, fax +44(0)20 7436 2013.

A report covering practical aspects of NGO experience of scaling up community work on HIV/AIDS, “Expanding community action on HIV/AIDS: NGO/CBO strategies for scaling up”, is available from the International HIV/AIDS Alliance. This is the report of the third year of the “Community Lessons, Global Learning” collaboration between the Alliance and Positive Action, GlaxoSmithKline’s Positive Action programme.

About the Alliance
The International HIV/AIDS Alliance is an international non-governmental organisation that supports communities in developing countries to prevent the spread of HIV, to support and care for those infected and to ease the impact of HIV on families and communities. Since its establishment in 1993, the Alliance has provided both financial and technical support to over 1,500 HIV/AIDS projects and has worked with NGOs and CBOs from over 40 countries.